Urethral Prolapse

Introduction

Prolapse of the urethra occurs when there is extrusion of the urethral mucosa out of the urethral orifice in male dogs.

It occurs most commonly in young (9-18 months), intact English bulldogs and Boston terriers and is rare in other breeds and unreported in the cat.

The condition is idiopathic, but is thought to occur during periods of excessive sexual excitement or may occur concurrently with urinary tract infections or urethral calculi.

Clinical Signs

The condition may be asymptomatic or there may be a history of haematuria, stranguria and pollakiuria.

The dog may lick its penis excessively and there may be bleeding from the tip.

A red, pea-shaped structure will be visible at the end of the penis.

Diagnosis

This is usually done on the basis of the history, clinical signs, and visualisation of the prolapse.

Further workup may be indicated for an underlying urinary disease, and urinalysis and culture as well as abdominal radiography and prostate palpation may be indicated.

Treatment

The prolapse should be reduced by placement of a urinary catheter and a purse string suture as a temporary measure.

This may be sufficient in some cases, but surgical correction is the treatment of choice in most cases as there is less recurrence.

Urethropexy: involves surgical resection of the prolapsed part of the urethra with a urinary catheter in place. The remaining cut end is sutured to the tunic of the penis with simple interrupted sutures of fine absorbable suture material. Resection can be performed for half the circumference of the penis at a time to prevent retraction of the mucosa and the need for stay sutures.

Post-operatively, an Elisabethan collar should be placed to prevent licking of the wound.

Any urinary tract infections should be treated with antibiotics according to culture and sensitivity results.

Castration is recommended in all cases, or dogs should be kept away from oestrous bitches.

Prognosis is generally good depending on the chronicity of the condition.

Urethral Prolapse Learning Resources
Flashcards Test your knowledge using flashcard type questions	Small Animal Soft Tissue Surgery Q&A 15

References

Mazzaferro, E. (2011) Blackwell's Five Minute Veterinary Consult Clinical Companion: Small animal ECC Wiley-Blackwell

Pasquini, C. (1999) Tschauner's Guide to Small Animal Clinics Sudz Publishing

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