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Created page with "==Introduction== Vaginal hyperplasia describes the '''exaggerated response to oestrogens''' by the vaginal and vestibular mucosa resulting in '''excessive mucosal folding''' of t..."
==Introduction==
Vaginal hyperplasia describes the '''exaggerated response to oestrogens''' by the vaginal and vestibular mucosa resulting in '''excessive mucosal folding''' of the vaginal floor cranial to the external urethral orifice. Redundant tissue '''protrudes through the vulva''' as a mass.
It usually occurs during '''prooestrus and oestrus''' and regresses spontaneously during the luteal phase.
Several grades of hyperplasia have been describes:
'''Type I''': slight eversion of the vaginal floor but no protrusion through the vulva
'''Type II''': vaginal tissue prolapses through the vaginal opening: tongue-shaped
'''Type III''': donut-shaped eversion of the entire vaginal wall, including the urethral orifice which can usually be seen ventrally.
Severe hyperplasia can lead to '''urethral obstruction''' and prevent urination.
The pathophysiology of the condition is an exaggerated response of the vaginal lining to oestrogens normally present during prooestrus and oestrus. Some bitches also have '''follicular cysts'''.
The condition is usually seen in '''younger bitches, typically during their first oestrous period'''.
Increased incidence has been reported in '''bulldogs, boxers and other brachycephalic breeds''', which might suggest an inherited component.
==Clinical Signs==
The bitch will have a history of being in prooestrus or oestrus.
There may be '''excessive licking of the vulva''', or straining to urinate.
A '''mass''' will usually be visible protruding from the vulva.
'''Vaginal examination''' will help determine the extend of the hyperplasia and prolapse, as well as the position of the urethral orifice.
The mass may be '''dry or necrotic''' due to it being subject to trauma, inflammation and ulceration.
==Treatment==
'''Conservative treatment''' is sufficient in the majority of cases, as the hyperplastic mucosa '''regresses''' at the onset of metoestrus when oestrogen concentrations decrease. The tissue will usually return to normal within a few weeks provided there has been no trauma.
'''Emollient creams''' may help keep the tissue moist until it regresses.
'''Ovariohysterectomy''' after the season is a permanent cure for the condition.
If the mass has become traumatised or necrotic, it will need to be resected via an '''episiotomy'''.
#Bitch in sternal recumbency, perineum prepped and purse-string suture around the anus
#Episiotomy performed: incising skin dorsally from the commissure of the vulva midline and deepening through subcutaneous tissues to the vestibule.
#Mass lifted from the vaginal flood and the redundant vaginal tissue is '''amputated''' by making a transvers elliptical incision around the base
#The vaginal defect is closed with simple iterrupted absorbable sutures marking sure the external urethral orifice isn't involved.
#The episiotomy is close in 2-3 layers, involving the vestibular mucose, the subcutaneous tissues and the skin.
Post-operatively, the bitch should be '''confined to a clean area''' to prevent contamination, and may benefit from the placement of a buster collar.
Affected animals should probably not be bred from, and an '''ovariohysterectomy''' should be performed.
{{Learning
|flashcards = [[Small Animal Abdominal and Metabolic Disorders Q&A 03]]
}}
==References==
Gregory, S. (2010) '''Surgical considerations of the female genital tract''' ''RVC student notes''
Mazzaferro, E. (2011) '''Blackwell's Five-Minute Veterinary Consult Clinical Companion: Small Animal ECC''' ''Wiley-Blackwell''
[[Category:To Do - Helen]]
[[Category:To Do - Review]]
Vaginal hyperplasia describes the '''exaggerated response to oestrogens''' by the vaginal and vestibular mucosa resulting in '''excessive mucosal folding''' of the vaginal floor cranial to the external urethral orifice. Redundant tissue '''protrudes through the vulva''' as a mass.
It usually occurs during '''prooestrus and oestrus''' and regresses spontaneously during the luteal phase.
Several grades of hyperplasia have been describes:
'''Type I''': slight eversion of the vaginal floor but no protrusion through the vulva
'''Type II''': vaginal tissue prolapses through the vaginal opening: tongue-shaped
'''Type III''': donut-shaped eversion of the entire vaginal wall, including the urethral orifice which can usually be seen ventrally.
Severe hyperplasia can lead to '''urethral obstruction''' and prevent urination.
The pathophysiology of the condition is an exaggerated response of the vaginal lining to oestrogens normally present during prooestrus and oestrus. Some bitches also have '''follicular cysts'''.
The condition is usually seen in '''younger bitches, typically during their first oestrous period'''.
Increased incidence has been reported in '''bulldogs, boxers and other brachycephalic breeds''', which might suggest an inherited component.
==Clinical Signs==
The bitch will have a history of being in prooestrus or oestrus.
There may be '''excessive licking of the vulva''', or straining to urinate.
A '''mass''' will usually be visible protruding from the vulva.
'''Vaginal examination''' will help determine the extend of the hyperplasia and prolapse, as well as the position of the urethral orifice.
The mass may be '''dry or necrotic''' due to it being subject to trauma, inflammation and ulceration.
==Treatment==
'''Conservative treatment''' is sufficient in the majority of cases, as the hyperplastic mucosa '''regresses''' at the onset of metoestrus when oestrogen concentrations decrease. The tissue will usually return to normal within a few weeks provided there has been no trauma.
'''Emollient creams''' may help keep the tissue moist until it regresses.
'''Ovariohysterectomy''' after the season is a permanent cure for the condition.
If the mass has become traumatised or necrotic, it will need to be resected via an '''episiotomy'''.
#Bitch in sternal recumbency, perineum prepped and purse-string suture around the anus
#Episiotomy performed: incising skin dorsally from the commissure of the vulva midline and deepening through subcutaneous tissues to the vestibule.
#Mass lifted from the vaginal flood and the redundant vaginal tissue is '''amputated''' by making a transvers elliptical incision around the base
#The vaginal defect is closed with simple iterrupted absorbable sutures marking sure the external urethral orifice isn't involved.
#The episiotomy is close in 2-3 layers, involving the vestibular mucose, the subcutaneous tissues and the skin.
Post-operatively, the bitch should be '''confined to a clean area''' to prevent contamination, and may benefit from the placement of a buster collar.
Affected animals should probably not be bred from, and an '''ovariohysterectomy''' should be performed.
{{Learning
|flashcards = [[Small Animal Abdominal and Metabolic Disorders Q&A 03]]
}}
==References==
Gregory, S. (2010) '''Surgical considerations of the female genital tract''' ''RVC student notes''
Mazzaferro, E. (2011) '''Blackwell's Five-Minute Veterinary Consult Clinical Companion: Small Animal ECC''' ''Wiley-Blackwell''
[[Category:To Do - Helen]]
[[Category:To Do - Review]]