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1.
Here, we describe two dogs in which canine small intestinal submucosa (SIS) was implanted as a biomaterial scaffold during perineal herniorrhaphy. Both dogs had developed severe muscle weakness, unilaterally herniated rectal protrusions, and heart problems with potential anesthetic risks. Areas affected by the perineal hernia (PH) located between the internal obturator and external anal sphincter muscles were reconstructed with naïve canine SIS sheets. In 12 months, post-operative complications such as wound infections, sciatic paralysis, rectal prolapse, or recurrence of the hernia were not observed. Symptoms of defecatory tenesmus also improved. Neither case showed any signs of rejection or specific immune responses as determined by complete and differential cell counts. Our findings demonstrate that canine SIS can be used as a biomaterial scaffold for PH repair in dogs.  相似文献   

2.
OBJECTIVES: To compare the expression of canine relaxin, relaxin-like factor (RLF), and relaxin receptors within the muscles of the pelvic diaphragm of dogs with perineal hernia (PH) and clinically normal dogs. STUDY DESIGN: In vivo comparative study. ANIMALS: Fifteen client-owned intact male dogs with PH were studied. Four mature intact male dogs with no evidence of perineal pathology served as controls. METHODS: Biopsy samples from the levator ani, coccygeus, and internal obturator muscles were obtained. RNA samples were reverse transcribed and analyzed by real-time PCR for the expression of canine relaxin receptor LRG7, relaxin, and RLF. RESULTS: Significantly higher expression levels of canine relaxin receptors occurred in the musculature of the pelvic diaphragm and internal obturator muscle in dogs with PH compared with normal dogs. Expression of canine RLF revealed no significant difference between dogs with PH and controls. The difference in the expression of canine relaxin between groups was not statistically significant. CONCLUSIONS: Relaxin receptor up-regulation occurs in the coccygeus, levator ani, and internal obturator muscles of dogs with PH. CLINICAL RELEVANCE: The higher expression of relaxin receptors within the muscles of the pelvic diaphragm in dogs with PH suggests that relaxin might play a role in the pathogenesis of PH. Atrophy of these muscles, which predisposes to PH, may be attributable to increased relaxin activity.  相似文献   

3.
OBJECTIVE: To evaluate the effectiveness of a herniorrhaphy technique, using an autogenous fascia lata graft (FLG) for perineal hernia (PH) repair in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: Twelve dogs with PH. METHOD: PHs were repaired with FLG harvested from the dog's ipsilateral thigh and sutured directly into the perineal defect. Correction of associated conditions, and castration were performed. Surgical time, pain, inflammation, pattern of defecation, lameness, hospitalization time, postoperative complications, and owner satisfaction were recorded. Histopathologic examination was performed in 1 dog euthanatized 10 months after repair. RESULTS: Hernia did not recur (mean follow-up, 5.8 months). Lameness was the most frequent minor complication, and was resolved within a few days. Transient rectal prolapse occurred in 2 dogs with bilateral PH. The mean (+/-SD) hospitalization was 1.8+/-0.9 days, and the surgical time was 76.5+/-9.8 minutes. Histopathologic examination in 1 dog revealed perfect integration of FLG into adjacent tissues without substantial tissue reaction. CONCLUSIONS: FLG reconstruction of PH is a simple, effective method of treatment. CLINICAL RELEVANCE: FLG can be used without major complications for primary repair of PH, as an augmentation procedure when the internal obturator muscle is thin or friable, or when herniation has recurred after another repair technique.  相似文献   

4.
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   

5.
A case of retroflexion of the urinary bladder into a bilateral perineal hernia in a female domestic shorthaired cat, three weeks postpartum, is reported. The bladder was repositioned and a cystopexy performed. A pelvic ostectomy was also carried out in order to alleviate the narrowing of the pelvic canal caused by an untreated acetabular fracture. Bilateral perineal herniorrhaphy was performed.  相似文献   

6.
Rectal abnormalities frequently coexist with perineal hernia. The three commonly recognized are deviation, sacculation, and diverticulum. If not corrected, these problems may lead to incomplete rectal emptying at defecation, persistent straining, and breakdown of the herniorrhaphy. Diagnosis of these abnormalities is by physical examination, with confirmation by barium enema. Amputation of rectal sacculations was performed during perineal herniorrhaphy on four dogs, three of which had previously had multiple recurrences of perineal hernia. None of the four experienced further straining or reherniation during a 12 to 16 month period following surgery.  相似文献   

7.
A sexually intact, male Chihuahua and a spayed female poodle were presented with left perineal masses. The masses were identified as perineal hernias by rectal palpation. Surgical exploration of the perineal region in each dog revealed retroperitoneal fat protruding between the sacrotuberous ligament and the coccygeus muscle (sciatic perineal hernia). The hernias were repaired using modifications of the standard or internal obturator flap herniorrhaphies. The levator ani muscle was grossly and histologically normal in the Chihuahua and grossly normal in the poodle. No short- or long-term complications were reported in either case. The management of sciatic perineal hernia is similar to the more common caudal perineal hernia.  相似文献   

8.
A technique that utilizes transposition of the internal obturator muscle for repair of perineal hernias was evaluated. Forty-two male dogs were followed for at least one year after surgery. The repair failed in only one animal, a dog with previously operated bilateral hernias. Microangiography demonstrated an adequate blood supply to the transposed internal obturator muscles of two dogs examined at three weeks and three months after surgery.  相似文献   

9.
Serum testosterone and estradiol 17-beta concentrations, and serum testosterone-to-estradiol ratio were evaluated in 15 dogs (greater than or equal to 5 years old) with perineal hernia (9 sexually intact males and 6 castrated males) and in 9 clinically normal sexually intact male dogs greater than or equal to 5 years old. There was no significant difference in serum testosterone-to-estradiol ratio between sexually intact male dogs with perineal hernia and clinically normal sexually intact male dogs. In castrated dogs with perineal hernia, serum testosterone concentration and testosterone-to-estradiol ratio were significantly (P less than 0.05) lower, compared with those values in sexually intact dogs with perineal hernia and in clinically normal sexually intact male dogs. There was no significant difference in serum estradiol 17-beta concentration among sexually intact male dogs with perineal hernia, castrated dogs with perineal hernia, and clinically normal sexually intact male dogs. Serum testosterone and estradiol 17-beta concentrations in dogs with perineal hernia did not differ from those values in clinically normal male dogs of the same age. Castration cannot be recommended for the treatment of perineal hernia unless a castration-responsive contributing factor such as prostatomegaly is identified, unless the pelvic diaphragm of dogs with perineal hernia has high sensitivity to normal or low serum testosterone and estradiol 17-beta concentrations, or unless there is documentation that other androgens and/or estrogens are involved.  相似文献   

10.
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   

11.
Perineal hernias almost exclusively affect male dogs (sexually intact or castrated). Factors that may contribute or predispose a dog to perineal hernias include tenesmus, pelvic musculature variations (male vs female), and gonadal hormone influence. In dogs with perineal hernias and tenesmus it is important to include rectal and prostatic diseases, including paraprostatic cysts, in the differential list of potential underlying causes. Surgical correction of the perineal hernia with a perineal herniorrhaphy is indicated. Successful treatment depends on the degree of preexisting neurologic alterations, meticulous surgical technique, and identification and correction of underlying contributing factors. Paraprostatic cysts develop predominantly in sexually intact medium to large breed dogs. These cysts are thin-walled structures often attached to the prostatic dorsal midline. Osseous metaplasia of paraprostatic cysts may occur. Clinical signs of tenesmus often result from compression on adjacent structures (urinary bladder and colon), and tenesmus may contribute to the development of perineal hernias. Preferred treatment of a paraprostatic cyst is surgical removal and castration. This report describes a dog with bilateral perineal hernias and a large mineralized paraprostatic cyst that was identified as a possible contributing factor to the hernias.  相似文献   

12.
The results of treatment of fifty-four dogs seen at the University of Pennsylvania Veterinary Hospital with perineal hernia were analysed. Conservative treatment was not satisfactory for dogs which strained to defaecate. Perineal herniorrhaphy was followed by recurrence of the hernia in 37% of the dogs; continued straining to defaecate, urinary problems and rectal prolapse were other post-herniorrhaphy sequelae. Anal splitting was performed in eight dogs; soiling of the anal area and occasional incontinence were reported in some dogs.  相似文献   

13.
A new surgical technique is described for the repair of perineal hernias. Transposition of both the internal obturator muscle and the superficial gluteal muscle together was used to repair 52 hernias in 44 dogs. The technique gave a strong pelvic diaphragm, fewer postoperative complications than other techniques and good long term results.  相似文献   

14.
Cases of perineal hernias in three cats are described. All the cats were male (2 castrated, 1 intact). The hernias were situated between the external anal sphincter and the levator ani muscle. The hernial sac contained a dilated rectum filled with fecal content (2 cats) as well as a small amount of retroperitoneal fatty tissue (2 cats) and urinary bladder (1 cat). A standard perineal herniorrhaphy in two cats, and herniorrhaphy via elevation of the internal obturator muscle in one cat were performed. No recurrence of the problem was observed in two cats during 9 months following the surgery. In one case, mild stretching of the pelvic diaphragm was noted with sporadic mild defecation problems observed after a 12-month period.  相似文献   

15.
In a series of 61 dogs examined for perineal hernia 12, (20 per cent) were found to have bladder retroflexion. Associated urinary signs were seen in only five dogs including one case with bladder rupture. Radiology was found to be the most consistently accurate means of diagnosis. Bladders were drained by catheterization, or by percutaneous or surgical cystocentesis before manipulative or surgical reduction. Conventional herniorrhaphy and castration were performed in all cases. Cystopexy was performed in only one case although recurrence of the retroflexion was not encountered in any dogs. Three dogs remained urinary incontinent after treatment.  相似文献   

16.
Summary

A modified technique for transposition of the internal obturator muscle was used to repair perineal hernias in 100 dogs. Complications and long‐term results are described. The most important complications were wound infection (45%), faecal incontinence (15%), and perineal fistula (7%). These complications often occurred in combination. The recurrence rate of perineal hernia was 5%.

Nine of the 15 patients with faecal incontinence had paresis of the external anal sphincter or faecal incontinence before surgery. We suggest that in numerous patients, faecal incontinence is a complication of the condition rather than a complication of treatment. The owner's assessment of the surgical result was good in 71% and moderate in 18% of the cases.  相似文献   

17.
Objectives : To perform a histological and immunohistochemical study of epidermal growth factor, transforming growth factor‐alpha and their receptor, as well as the apoptotic signal active caspase‐3 in the levator ani muscle of dogs with and without perineal hernia. Methods : Biopsy specimens of the levator ani muscle were obtained from 25 dogs with perineal hernia and 4 non‐affected dogs and were processed for Masson and immunohistochemical staining. Results : The affected dogs exhibited myopathological features, internalised nuclei, destruction and abnormal size of muscle fibres, which were replaced by collagen. The immunohistochemical study revealed active caspase‐3, epidermal growth factor, transforming growth factor‐alpha and epidermal growth factor receptor in the levator ani. Compared to the healthy muscle, transforming growth factor‐alpha staining intensity was lower in the affected muscle, whereas epidermal growth factor receptor and active caspase‐3 staining were higher. Clinical Significance : Pelvic diaphragm muscle weakening is the leading cause of perineal hernia in the dog. Survival and death signals expressed in these muscles may contribute to the pathogenesis of this disease. This study reports epidermal growth factor, transforming growth factor‐alpha and epidermal growth factor receptor immunohistochemical expression in the skeletal muscle and suggests that perineal hernia in the dog is accompanied by levator ani muscle atrophy, increased expression of epidermal growth factor receptor, caspase‐3 activation, and decreased expression of transforming growth factor‐alpha.  相似文献   

18.
SUMMARY Thirty-five male dogs with perineal hernia were seen at Sydney University Veterinary Hospital and Clinic over a five-year period from 1975 to 1979. The Corgi breed was most commonly affected, but Kelpies and Boxers were also over-presented when compared to the general clinic population. The mean age of affected dogs was 9.4 years and the mean body weight 16 kg. There were 11 bilateral and 24 unilateral herniae. Thirty-two dogs underwent herniorrhaphy. A recurrence rate of 15.4% was found in 26 dogs followed up for more than six months, this rate comparing favourably with a number of other reported series. The major post-operative complication was wound infection or breakdown, seen in 28.6% of dogs.  相似文献   

19.
This case report records a unilateral perineal hernia in a 7-year-old female donkey. The donkey had a history of unilateral swelling lateral to the left vulvar lip and difficulty in defaecation. Upon palpation, the swelling was painless, soft and reducible. Ultrasonography revealed a hyperechoic hernia sac containing dilated nonmotile bowel with homogenous hypoechoic contents. Primary herniorrhaphy was performed after repositioning of the herniated bowel. The donkey made an uneventful recovery with no recurrence or complications for 6 months of available follow-up. In conclusion, perineal hernia should be considered in the differential diagnosis of perineal swellings in donkeys. Clinical examination, ultrasonography and surgical exploration are valuable for definite diagnosis of perineal hernia in donkeys. Surgical herniorrhaphy was successful in correcting the problem in this case.  相似文献   

20.
A modified technique for transposition of the internal obturator muscle was used to repair perineal hernias in 100 dogs. Complications and long-term results are described. The most important complications were wound infection (45%), faecal incontinence (15%), and perineal fistula (7%). These complications often occurred in combination. The recurrence rate of perineal hernia was 5%. Nine of the 15 patients with faecal incontinence had paresis of the external anal sphincter or faecal incontinence before surgery. We suggest that in numerous patients, faecal incontinence is a complication of the condition rather than a complication of treatment. The owner's assessment of the surgical result was good in 71% and moderate in 18% of the cases.  相似文献   

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