Difference between revisions of "Vaginal Hyperplasia"
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==Introduction== | ==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. | 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 ''' | + | It usually occurs during '''proestrus and oestrus''' and regresses spontaneously during the luteal phase. |
| − | Several grades of hyperplasia have been | + | Several grades of hyperplasia have been described: |
| − | + | :'''Type I''': slight eversion of the vaginal floor but no protrusion through the vulva | |
| − | '''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. | |
| − | '''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. | 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 | + | The pathophysiology of the condition is an exaggerated response of the vaginal lining to oestrogens normally present during proestrus and oestrus. Some bitches also have '''follicular cysts'''. |
The condition is usually seen in '''younger bitches, typically during their first oestrous period'''. | The condition is usually seen in '''younger bitches, typically during their first oestrous period'''. | ||
| Line 21: | Line 19: | ||
==Clinical Signs== | ==Clinical Signs== | ||
| − | The bitch will have a history of being in | + | The bitch will have a history of being in proestrus or oestrus. There may be '''excessive licking of the vulva''', or straining to urinate. A '''mass''' will usually be visible protruding from the vulva. |
| − | |||
| − | 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. | '''Vaginal examination''' will help determine the extend of the hyperplasia and prolapse, as well as the position of the urethral orifice. | ||
| Line 39: | Line 33: | ||
If the mass has become traumatised or necrotic, it will need to be resected via an '''episiotomy'''. | 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 | + | #Bitch is positioned in sternal recumbency, perineum prepped and purse-string suture placed around the anus. |
| − | #Episiotomy performed | + | #Episiotomy is performed by incising skin dorsally from the commissure of the vulva midline and deepening through subcutaneous tissues to the vestibule. |
| − | # | + | #The mass is lifted from the vaginal floor and the redundant vaginal tissue is '''amputated''' by making a transverse elliptical incision around the base. |
| − | #The vaginal defect is closed with simple | + | #The vaginal defect is closed with [[Suture Patterns|simple interrupted]] [[Suture Materials|absorbable sutures]] marking sure the external urethral orifice isn't involved. |
| − | #The episiotomy is | + | #The episiotomy is closed in 2-3 layers, involving the vestibular mucosa, 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. | Post-operatively, the bitch should be '''confined to a clean area''' to prevent contamination, and may benefit from the placement of a buster collar. | ||
| Line 58: | Line 52: | ||
Mazzaferro, E. (2011) '''Blackwell's Five-Minute Veterinary Consult Clinical Companion: Small Animal ECC''' ''Wiley-Blackwell'' | Mazzaferro, E. (2011) '''Blackwell's Five-Minute Veterinary Consult Clinical Companion: Small Animal ECC''' ''Wiley-Blackwell'' | ||
| − | [[Category: | + | |
| − | [[Category: | + | {{review}} |
| + | |||
| + | ==Webinars== | ||
| + | <rss max="10" highlight="none">https://www.thewebinarvet.com/urogenital-and-reproduction/webinars/feed</rss> | ||
| + | |||
| + | [[Category:Reproductive Diseases - Dog]] | ||
| + | [[Category:Female Reproductive System - Pathology]] | ||
| + | [[Category:Expert Review - Small Animal]] | ||
Latest revision as of 16:25, 5 January 2023
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 proestrus and oestrus and regresses spontaneously during the luteal phase.
Several grades of hyperplasia have been described:
- 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 proestrus 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 proestrus 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 is positioned in sternal recumbency, perineum prepped and purse-string suture placed around the anus.
- Episiotomy is performed by incising skin dorsally from the commissure of the vulva midline and deepening through subcutaneous tissues to the vestibule.
- The mass is lifted from the vaginal floor and the redundant vaginal tissue is amputated by making a transverse elliptical incision around the base.
- The vaginal defect is closed with simple interrupted absorbable sutures marking sure the external urethral orifice isn't involved.
- The episiotomy is closed in 2-3 layers, involving the vestibular mucosa, 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.
| Vaginal Hyperplasia Learning Resources | |
|---|---|
 Test your knowledge using flashcard type questions |
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
 |
This article has been peer reviewed but is awaiting expert review. If you would like to help with this, please see more information about expert reviewing. |
Webinars
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