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1.
OBJECTIVES: Palliative surgery for advanced-stage prostatic cancers was tested with regard to survival rate and complications in a prospective randomised clinical study of dogs. Currently, therapeutic approaches have a grave long-term prognosis in clinically significant prostatic cancer. METHODS: Of 167 dogs with prostatic disorders, 24 were diagnosed with prostatic cancer. Eleven dogs underwent subtotal intracapsular prostatectomy, while in 10 dogs total prostatectomy was performed. The remaining three dogs were euthanased at their owner's request. Dogs treated by subtotal intracapsular prostatectomy and those treated by total prostatectomy were followed until their death. RESULTS: It was found that dogs treated by subtotal intracapsular prostatectomy survived 5.63 times longer (mean [sd] 112.0 [63.03] days) than those treated by total prostatectomy (19.9 [10.67] days) (P<0.01). Moreover, a significant decrease in postoperative complications after subtotal intracapsular prostatectomy was recorded, especially with regard to urinary incontinence. CLINICAL SIGNIFICANCE: It was concluded that, in the authors' facility, treatment of prostatic cancer by subtotal intracapsular prostatectomy was superior to that by total prostatectomy, with respect to both postoperative survival and serious complications.  相似文献   

2.
Twenty dogs with abscessation of the prostate gland were treated by celiotomy, drainage, and digital exploration of the gland through bilateral capsulectomy wounds. Omentum was introduced through the capsulectomy wounds and packed into the abscess cavities around the prostatic urethra. Most dogs were discharged from the hospital within 48 hours of the surgery. Long-term resolution of the problem (no recurrence within 12 months) was achieved in 19 dogs. One dog had recurrent abscessation that was managed by the placement of dependant Penrose drains. Temporary tube cystostomy was performed postoperatively in one dog for the management of transient dysuria. One dog with septic peritonitis resulting from preoperative abscess rupture was managed by concurrent open peritoneal drainage. Intracapsular prostatic omentalization was a simple and effective means of managing prostatic abscessation with minimal requirement for postoperative hospitalization of the patient. The frequency of serious complications, including postoperative urinary incontinence, was low.  相似文献   

3.
OBJECTIVE: To report a technique for partial prostatectomy by laser dissection and to evaluate outcome and complications in dogs with prostate carcinoma (PCA). STUDY DESIGN: Experimental and clinical case series. ANIMALS: Four normal dogs and 8 dogs with PCA. METHODS: Subcapsular partial prostatectomy, sparing the urethra and the dorsal aspect of the prostatic capsule, using Nd:YAG laser dissection to remove the prostatic parenchyma and control hemorrhage was performed in 4 normal dogs and subsequently in 8 dogs with histologically confirmed PCA. Additional treatment of PCA dogs included local application of interleukin-2 and systemic administration of meloxicam. Prostate size, complications, and survival time were recorded. Laser-associated thermal damage to surrounding tissue was evaluated by histology. RESULTS: In normal dogs, no damage to the dorsal prostatic capsule or urethra was detected. In PCA dogs, median survival was 103 days (range, 5-239 days). Three dogs died from complications within 16 days, whereas 5 (median survival, 183 days; range, 91-239 days) had improvement or resolution of clinical signs. Urinary incontinence did not occur. CONCLUSION: Laser assisted subcapsular partial prostatectomy can be performed in dogs with PCA without development of postoperative incontinence. CLINICAL RELEVANCE: Subcapsular partial prostatectomy is a potential palliative treatment for PCA in dogs and may lead to the resolution of clinical signs for several months.  相似文献   

4.
Objective- The purpose of this study was to determine the results of a new technique for management of prostatic retention cysts in dogs.
Study Design- A retrospective clinical study.
Animals- Eighteen client-owned dogs.
Methods- Dogs with prostatic retention cysts were treated by celiotomy and drainage of the cysts. The majority of the cyst wall was resected and residual cyst cavities were packed with omentum. All dogs were castrated.
Results- Long-term resolution of clinical signs was achieved in all dogs, with follow-up periods ranging from 6 to 42 months. Five dogs developed urinary incontinence postoperatively. This persisted in two dogs, but was well controlled with phenylpropanolamine. In the remaining dogs, the incontinence was transient and resolved within 2 months of surgery.
Conclusions- Partial cyst resection combined with omentalization and castration was a simple and effective means of managing prostatic retention cysts. The incidence of serious complications, including postoperative urinary incontinence, was low.  相似文献   

5.
Introduction:  Complete prostatectomy with healing and normal urinary function is reported for some prostatic diseases. However incontinence rates of up to 100% for neoplasia‐affected dogs have dampened surgeons' enthusiasm for performing prostatectomies. Hypothesizing that incontinence following prostatectomy for prostatic cancer is related to extensive dissection associated with advanced invasion, it is proposed that there exists a subset of dogs with prostatic cancer that require minimal dissection and have the potential for quality survival for pet and owner.
Materials and Methods:  Dogs that received prostatectomy for neoplasia were qualitatively reviewed for commonalities associated with an outcome viewed as successful by owner and veterinarian.
Results:  Early diagnosis (prostatomegaly‐castrated population, high index of suspicion, ultrasound guided cytology) with referral center staging (ultrasound, contrast CT) enabled selection of appropriate surgery (urinary drainage, stent, prostatic enucleation, extrapelvic urethral anastomosis, cystoprostatourethrectomy with ureterocolonic anastomosis) for several dogs.
Conclusions:  A massive demographic shift toward castrated dogs and widespread availability of abdominal u/s can distinguish dogs that may benefit from advanced staging technology and treatment for locally confined prostatic neoplasia.
Application:  Step one is local control. Though based on a dribble of cases, it is clear that some dogs with prostatic cancer can be cured and live high quality lives. We wanted to leak these results so that oncologists will encourage early aggressive investigation and referral for prostatomegaly in castrated dogs.  相似文献   

6.
Percutaneous nephrostomy catheters modified by cutting off the tubing connectors were implanted in three dogs with prostatic neoplasia to relieve or prevent stranguria. One catheter was implanted with a guide wire through a perineal urethrotomy, and two catheters were implanted via celiotomy and cystotomy. Morbidity and complications were minimal. Inflammation of the abdominal incision was present from day 4 to day 8 in the dogs with celiotomy. Urinary incontinence was continuous in one dog and intermittent in two dogs. Hematuria occurred in two dogs. The retained urethral catheter was a suitable palliative treatment for urethral obstruction in three dogs with prostatic neoplasia.  相似文献   

7.
Eleven of 20 dogs (55%) were incontinent after surgical treatment of ureteral ectopia. Ureterocystostomy was performed in 15 dogs, ureteral transection and bladder reimplantation in four dogs, and ureteronephrectomy in one dog. Siberian huskies had a significantly higher rate of persistent postoperative incontinence than other breeds. There was no difference in postoperative incontinence between dogs with unilateral and bilateral ectopia. Concurrent bacterial cystitis was not associated with persistent postoperative incontinence. Age at the time of surgical correction had no effect on the rate of postoperative incontinence. Eight incontinent dogs were treated medically; three are continent with medication, three are improved but still incontinent, and two did not improve.  相似文献   

8.
Prostatectomy in dogs with clinical prostatic disease has been associated with a high incidence of urinary incontinence. In this study, urodynamic alterations after prostatectomy in 10 dogs without clinical prostatic disease were evaluated. Measurements of residual urine volume, simultaneous urethral pressure profilometry and electromyography, and carbon dioxide cystometry were made before and 14 and 20 weeks after prostatectomy. Voiding was observed daily for 20 weeks after prostatectomy. All dogs remained continent for 20 weeks after prostatectomy, and only minor urodynamic abnormalities were noted. Castration had no effect on urodynamic changes associated with prostatectomy. Prostatectomy produced minimal functional changes in dogs without clinical prostatic disease.  相似文献   

9.
Factors that predict postoperative continence and incontinence were evaluated in 33 female dogs with surgically corrected ectopic ureters. The current study found that intramural or extramural, left- or right-sided, and unilateral or bilateral ectopic ureters were not significant factors influencing postoperative incontinence in affected dogs. The presence of either hydroureter or urinary tract infection was also not significantly associated with postoperative incontinence. Dogs with ectopic ureters that were incontinent postsurgically tended to remain unresolved.  相似文献   

10.
Eleven dogs were diagnosed as having solitary or multiple prostatic cysts in an abdominal, pelvic or perineal position. Common presenting signs included urinary dysfunction, faecal tenesmus and abdominal distension. Cystography was found to be the most consistently accurate technique for differentiating the cysts from the bladder and other abdominal soft tissue masses whilst urethrography often highlighted their prostatic origin. Complete surgical resection of the cysts was attempted in nine dogs, the complexity of dissection being dictated by cyst size and the extent of adhesions to adjacent organs. Nine dogs were castrated. Urinary incontinence continued post-operatively in four dogs but later resolved in three of these. Seven dogs were alive and symptom-free over post-operative periods ranging from one to three years. Despite some of its technical difficulties, surgical excision appears to be a successful approach to even the larger prostatic cysts. Few of the post-operative complications associated with other surgical procedures described for the management of cysts were encountered.  相似文献   

11.
A technique was developed for subtotal prostatectomy in dogs with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. In six normal dogs, full-thickness necrosis of the prostate occurred if the central-lateral region within 5 mm of the urethra was photoablated at 60 watts for 1 second. Moderate to superficial necrosis occurred when the prostate within 5 mm of the urethra was photoablated at 35 watts for 2 seconds or 60 watts for 0.5 second. At necropsy, leakage of the urethra occurred in two dogs at sites treated at 60 watts for 1 second. In a clinical study, complications associated with subtotal prostatectomy with the Nd:YAG laser (n = 6) were compared with complications associated with prostatic drainage (n = 6) in dogs with prostatic disease. Intraoperative death (2/6 dogs) and nocturnal incontinence (4/4 surviving dogs) occurred with subtotal prostatectomy. Uncontrolled prostatic infection (2/6 dogs) occurred with prostatic drainage and resulted in the death of one dog on day 11. Four of five dogs surviving prostatic drainage developed recurrent urinary tract infection.  相似文献   

12.
Subtotal intracapsular prostatectomy was performed on five normal dogs. All dogs were maintained for 60 days postoperatively. No urinary abnormalities were noted following surgery with the exception of transient urinary incontinence in one dog that lasted for 7 days. Upon termination of the study, the prostatic urethra had reepithelized in all dogs where a dorsal strip of epithelium was left in place during surgery.  相似文献   

13.
OBJECTIVE: To evaluate the value of laparotomy as the initial step in the treatment of bilateral or complicated perineal hernia (PH) in dogs. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: Forty-one dogs with PH. METHODS: Dogs with bilateral or complicated PH treated by a 2-step approach between November 1997 and December 2001 were studied. Inclusion criteria for complicated PH were: recurrence of PH, unilateral PH with a major rectal dilatation, PH with a concurrent surgical prostatic disease, and PH with retroflexed bladder. Colopexy, vas deferens pexy, cystopexy, and prostatic omentalization were performed during laparotomy as needed. Later, PH was performed by internal obturator muscle flap (IOMF) or if there was a perineal rent or weakness on the contralateral side, appositional herniorrhaphy was performed. Outcome was followed for >/=6 months. RESULTS: PH were bilateral (20 dogs) or unilateral (21). Twenty-one (51%) dogs had prostatic disease (clinical or ultrasonography diagnosis; 17 confirmed histologically) and 12 (29%) had urinary bladder retroflexion. Forty-one colopexies, 32 vas deferens pexies, 6 cystopexies, and 9 prostatic surgeries (omentalization or perineal cyst resection) were performed. PH was performed 2-20 days (median, 6 days) later: 61 IOMF transpositions, 13 appositional. Mean follow-up time was 26.6 months (range, 6-54 months, median, 27 months). PH was resolved in 37 (90%) dogs; 4 dogs had recurrence, and all occurred within 6 months. Thirty-eight (92%) dogs had an improved quality of life (good in 34 dogs, fair in 4 dogs). Wound complications occurred in 7 dogs (17%). Postoperative urine dribbling occurred in 15 dogs (37%) and was irreversible in 7 dogs (17%). Postoperative fecal straining persisted in 18 dogs (44%), and was permanent in 4 dogs (10%). Fecal incontinence did not occur. CONCLUSIONS: In bilateral or complicated PH, fixation of the urinary bladder and colon, and treatment of prostatic disease increase the chances of resolution. Emptying of the perineal space by organ pexy allows improved observation during herniorrhaphy. Despite a 90% clinical resolution, dogs with complicated PH treated by a 2-step protocol may have persistent urinary and fecal disorders. CLINICAL RELEVANCE: To improve the prognosis of bilateral or complicated PH, investigation and treatment of concomitant lesions (rectal, prostatic, bladder) should be part of a rational surgical strategy using a 2-step protocol.  相似文献   

14.
Disorders of the urinary system are common in geriatric dogs. Common urinary disorders that are seen in older dogs include chronic renal failure, urinary incontinence, bladder tumors, and prostate problems. Therapy for chronic renal failure is aimed at both slowing the progression of the disease and ameliorating the signs of uremia. Therapeutic recommendations for the conservative medical management of chronic renal failure include reducing dietary protein, moderately reducing salt intake, maintaining normal serum phosphorus levels, providing free access to water, avoiding stress, supplementing water soluble vitamins, using anabolic steroids to treat the anemia of chronic renal failure, treating acidosis, and controlling hypocalcemia. Urinary incontinence can often be controlled or eliminated. The appropriate approach to management of this disorder is to identify and remove specific causes. Common causes of urinary incontinence are urethral incompetence, urinary tract infection, and polyuria and polydypsia. Bladder tumors are, fortunately, not a common tumor of dogs, but are more common in geriatric dogs than in the young. The most common bladder tumor is the transitional cell carcinoma. Therapy for this tumor is usually palliative because of its malignant nature and because it is usually located in the neck of the bladder. Its location in the bladder often makes it impossible to resect the tumor completely without removing the entire bladder and diverting the ureters. New chemotherapeutic modalities are being evaluated that may increase life expectancy after diagnosis and, therefore, improve prognosis. Prostate disease is also seen in older dogs. Types of prostate abnormalities seen in dogs include prostatic hyperplasia, cysts, abscesses, acute and chronic infection, and neoplasia. The institution of proper therapy requires an accurate diagnosis; neutering is often recommended as a part of therapy regardless of the type of prostatic disease present.  相似文献   

15.
OBJECTIVE: To assess cystoscopic transurethral resection (TUR) for the palliative management of dogs with neoplastic infiltration of the urethra. STUDY DESIGN: Prospective clinical trial. ANIMALS: Six client-owned dogs. METHODS: Cystoscopic examination and electrosurgical TUR were performed in dogs with urination difficulties caused by prostatic or urethral neoplasia. TUR was performed in a retrograde manner in female dogs and antegrade in male dogs via exploratory celiotomy and ventral cystotomy. Cystoscopic examination was used to determine the extent of neoplastic involvement of the urethra. TUR involved piecemeal removal of neoplastic tissue from the urethral lumen using an electrocautery cutting loop. Hemorrhage was controlled with a cystoscopic cauterized roller-ball. In 2 male dogs, intraoperative radiation therapy (IORT) was used to treat both prostatic neoplasia and the sublumbar lymph node bed. Surgical technique, complications, adjuvant treatment, and outcome were recorded. RESULTS: TUR was performed in 3 male dogs with prostatic carcinoma and 2 female dogs with urethral transitional cell carcinoma (TCC). In 1 female dog, TUR was attempted but not successful because of cystoscope diameter. Iatrogenic urethral perforation occurred during TUR in 3 dogs. In 2 dogs, prolonged exposure to lavage fluid resulted in clinical and biochemical abnormalities consistent with TUR syndrome. Dysuria resolved in 5 dogs within 10 days of TUR. Treatment-related complications included urinary tract infection and tumor seeding. Local tumor progression and metastasis occurred in all dogs. CONCLUSIONS: TUR (in combination with chemotherapy+/-IORT) resulted in rapid palliation of urination difficulties in male dogs with prostatic carcinoma. In female dogs with urethral TCC, however, electrosurgical TUR cannot be recommended because of a high intra- and postoperative complication rate with no improvement in postoperative management compared with historical reports of tube cystostomy. CLINICAL RELEVANCE: TUR is a novel alternative for the palliation of male dogs with prostatic carcinoma. In female dogs with urethral TCC, electrosurgical TUR does not provide any advantages compared with tube cystostomy.  相似文献   

16.
Thirty-two spayed bitches with urinary incontinence due to urethral sphincter incompetence, non-responsive to phenylpropanolamine administration, were treated by urethral submucosal injection of glutaraldehyde cross-linked collagen. Urinary incontinence resolved after a single injection in 19 of the bitches. Additional medication with phenylpropanolamine was necessary in five of these dogs, however. Of the 13 bitches that remained incontinent, the injections were repeated in nine. This resulted in a return to continence in five dogs, although two of these required additional medication for complete continence. The cure rate due to collagen injections alone is 53 per cent (17 of the 32 cases). A total of 41 injections were performed and no postoperative complications were observed.  相似文献   

17.
Serum and seminal plasma concentrations or activities of acid phosphatase (AP), prostate specific antigen (PSA), and canine prostate specific esterase (CPSE) were measured in normal dogs, dogs with benign prostatic hyperplasia (BPH), dogs with bacterial prostatitis, and dogs with prostatic carcinoma to determine if these assays would be of value in differentiating dogs with prostatic carcinoma from normal dogs, and dogs with other prostatic disorders. In addition, tissue sections of prostatic adenocarcinomas were stained with antiprostatic AP, anti-CPSE, and anti-PSA antibodies to determine if these would be suitable immunohistochemical markers of prostatic carcinoma. Prostate-specific antigen was not detected in canine serum or seminal plasma. Serum and seminal AP activities did not differ significantly between normal dogs and those with prostatic diseases, or among dogs with different prostatic disorders. Serum CPSE activities were significantly higher in dogs with BPH than in normal dogs. Mean serum CPSE activities in dogs with BPH, bacterial prostatitis, and prostatic carcinoma were not significantly different from each other. Slight to moderate immunohistochemical staining of canine prostatic adenocarcinomas was noted for prostatic AP and PSA; most tumors did not stain for CPSE. These results show that proteins of prostatic origin appear in the serum of dogs as a result of prostatic pathology, especially BPH. Canine prostatic adenocarcinoma does not appear to be associated with significant increases in CPSE or AP activities, possibly because of down-regulation of these enzymes by prostatic carcinoma cells. It is also possible that failure to detect significant differences resulted from limited statistical power for some groups and pairwise analyses because of the small number of dogs evaluated.  相似文献   

18.
Reconstruction of the proximal urethra using a distally based tube flap mobilized from the ventral bladder wall was performed on 12 clinically normal dogs after total prostatectomy and resection of 2 cm of membranous urethra. One dog was euthanized at 6 hours and one at 36 hours after surgery because of surgical complications. Five dogs were euthanized at 10 days, two dogs at 6 weeks and three dogs at 12 weeks. Advancement of the tube flap allowed for tension-free anastomosis to the membranous urethra. Vascular integrity was maintained in all flaps. Intermittent to continuous postoperative urinary incontinence occurred in 7 of 10 dogs. The incontinence was transient in all 6 and 12 week dogs except one in which a persistent stress incontinence developed. Mild to severe dysuria was noted in 8 of 10 dogs, but was also transient in all of the 6 and 12 week dogs, with the exception of one dog. Postoperative urethral closure pressure profilometry revealed decreased tone in the membranous urethra in all 6 and 12 week dogs. It was concluded that proximal urethral reconstruction, using a ventral bladder tube flap, is a viable technique that may permit functional urodynamic recovery in dogs with significant proximal urethral loss.  相似文献   

19.
The results of treatment of 31 dogs with perineal hernia by internal obturator muscle transposition were evaluated by comparing the clinical signs reported by the owner before surgery with those reported 11 or more months following surgery. The severity and frequency of pre- and postoperative clinical signs were categorized numerically, and composite scores were obtained for each dog. In addition, the dogs were examined 11 or more months following surgery. The presence or absence of an externally obvious perineal swelling was noted, and rectal examination was performed to detect rectal sacculation and the integrity of the pelvic diaphragm dorsal and ventral to a line drawn between the center of the anus and the ischiatic tuberosity. These results were correlated with the postoperative composite scores. Postoperative complications included wound infection (2), wound seroma (2), rectal prolapse (4), urinary incontinence (2), and flatus as a new postoperative problem (11). The postoperative composite score was significantly lower (improved function) following surgery. Dogs with worse signs preoperatively or bilateral perineal hernia benefited less from surgery. More dogs showed improvement when the operation was performed by experienced surgeons. Factors detected at follow-up examination that correlated with more severe postoperative clinical signs were perineal swelling, absence of the ventral portion of the pelvic diaphragm, and rectal sacculation. The presence or absence of reformation of the dorsal aspect of the pelvic diaphragm did not correlate with postoperative clinical signs.  相似文献   

20.
Historical and physical signs associated with prostatic disease diagnosed in dogs over a 5.5-year period were defined. One hundred seventy-seven male dogs were determined to have prostatic abnormality. Of the 177 dogs, 87 were determined to have specific prostatic disease. The most common prostatic disease identified in this study was bacterial prostatitis, followed by prostatic cyst, prostatic adenocarcinoma, and benign hyperplasia. The most common prostatic disease identified in neutered dogs was prostatic adenocarcinoma. Mean age at onset of prostatic disease was 8.9 years; statistically significant difference was not observed between age at onset of the various types of prostatic disease identified. Doberman Pinscher was the most common breed with prostate disease. Twenty-nine percent of dogs with a specifically identifiable prostatic disease had signs of systemic illness, 41% had signs of lower urinary tract disease, 28% had signs of gastrointestinal tract abnormalities, and 13% had signs of locomotor difficulty.  相似文献   

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