Köpeklerde Perineal Fıtıkların Sağaltımında Dört Tekniğin Bir Arada Kullanılmasının Nüksleri Önlemedeki Etkinliği: Obturator Internus Kas Transpozisyonu, Kastrasyon, Sistopeksi ve Kolopeksi

Perineal fıtık, pelvik diyaframı oluşturan bileşenlerin güçsüzlüğü sonucu, idrar kesesi, bağırsaklar, retroperitoneal yağ doku veya prostat gibi intraabdominal yapı ve organların perineal bölgeye fıtıklaşmasıdır. Tedavisinde klasik herniorafi dışında farklı kasların transpozisyonu, çeşitli prostetik implantlar ve biomateryaller kullanılmaktadır. Çalışmamıza farklı ırk ve yaşta 11 adet erkek köpek dahil edildi. Hastalar, perineal bölgede şişlik, ağrılı defekasyon, dışkıda kan ve strangüri gibi şikayetlerle getirilmişlerdi. Perineal fıtık tanısı, klinik muayene ve rektal palpasyon bulgularına göre kondu. Perineal fıtık tanısı konan 11 hastadan 10 'u, obturator internus kas transpozisyonu, kastrasyon, sistopeksi ve kolopeksi işlemleri aynı seansta uygulanarak sağaltıldı ve hastalar kısa ve uzun dönem nüks ve diğer bazı komplikasyonlar açısından değerlendirildi. Bir hastada ise hasta sahibi yavru almak istediği için kastrasyon yapılamadı. Çalışmanın sonucunda 11 hastanın 10 'unda uzun dönem nüks şekillenmedi. Önemli sayılabilecek bir postoperatif komplikasyonla karşılaşılmadı. Sonuç olarak, postoperatif nüks oranları %36-48 lere kadar ulaşabilen perineal fıtıkların sağaltımında, obturator internus kas transpozisyonu, kastrasyon, sistopeksi ve kolopeksinin eş zamanlı uygulanmasının postoperatif uzun dönem nüksleri engellemede faydalı olabileceği kanısına varıldı

Prevention of Perineal Hernia Recurrences by Four-In-One Procedure in Dogs: Obturator Internus Muscle Transposition, Castration, Cystopexy and Colopexy

Perineal hernia is caudal dispacemet of intraabdominal structure and organs such as the urinary bladder, intestines, retroperitoneal fat or prostate to the perineal region because of weakness and deficiency of pelvic diaphragm. In treatment, different muscle transposition tecniques, various prosthetic implants and biomaterials are used beside of traditional herniography. Eleven male dog with different age and breed was included in this study. These patients were brought by the complaints of perineal swelling, blood in feces, painful defecation and stronguria. Perineal hernia diagnosis was made by clinical examination and rectal palpation. Perineal hernias was treated by obturator internus muscle transposition, castration, cystopexy and colopexy in the same session in 10 of 11 patient and the postoperative complications and short and long term recurrence was evaluated. In one patient, owner of the dog did not give permission to castration since he wanted to use his dog for breeding. At the end of the study, postoperative long term reccurrence was not determined in 10 of 11 patient. No significant postoperative complications were noted. As a result, in the treatment of perineal hernias that have postoperative recurrence rates up to 36-48%, it was concluded that simultaneous using of obturator internus muscle transposition, castration, cystopexy and colopexy can be useful in preventing postoperative long term recurrence in dogs

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