Transposição uretral pré-púbica mediante secção peniana em cães. Estudo experimental e clínico

Abstract

Urethral stenosis is still a challenge for urological surgeons even though there are several corrective techniques in humans. In veterinary medicine there are few alternatives, especially in dogs affected by extensive intra-pelvic lesions and the usual treatment in the clinical routine is prepubic urethrostomy, a procedure related to several complications. Before research aimed at describe an innovative surgical technique of prepubic urethral transposition to restore urinary flow interrupted by stenosis of extensive segments of the membranous urethra in adult male dogs. This study was developed in two stages that occurred concomitantly. In one of the stages, 18 adult male dogs from Hospital de Clínicas Veterinaria of the Universidade Federal de Pelotas (HCV/UFPel) were used. The surgical technique consisted initially of orchiectomy, followed by celiotomy, transverse section of the penis in the pre-scrotal region and transposition into the abdominal cavity making anastomosis to the prostatic urethra. In this stage, the feasibility of the technique, surgical time, description of the anatomical planes discussed, pre and postoperative length of the urethra were evaluated, and then submitted to retrograde contrast-enhanced urethrocystography for evaluation of anastomosis effusion, urethral diameter and constriction in the anastomosis. In the other stage, the same surgical technique was applied to six male dogs treated at the HCV/UFPel, which were affected by extensive stenosis of the intra-pelvic urethra, with prepubic urethral transposition as an alternative to prepubic urethrostomy and genitalia ablation external. These six dogs were evaluated clinically and by urethrocystographies with intervals between seven and 48 XX months post-procedure, none of which presented voiding or stenosis images. It is concluded that the prepubic urethral transposition is a feasible technique in dogs, effective in maintaining the diameter and sealing of the anastomosis, giving a new urethral pathway to restore the urinary flow.