By William E. Schultz, DVM For the Education Center
Urethral prolapse, a condition where the urethral mucosa extends beyond the penis, is more frequently diagnosed in young male English bulldogs and Boston terriers. While the exact cause remains unknown, it is often associated with sexual excitement and genitourinary infections. Symptoms include sporadic bleeding, tenesmus, and an unfocused urine stream. In severe cases, self-inflicted trauma or drying may lead to necrosis of the exposed urethral mucosa.
To ensure an accurate diagnosis, it’s essential to rule out other potential causes of hematuria and penile bleeding, such as urethritis, neoplasia, or urinary tract infections. Once diagnosed, surgical resection is the recommended treatment. Traditionally, this procedure involved using a scalpel and a tourniquet to control bleeding. However, with the advent of CO2 laser technology, a tourniquet is no longer necessary, resulting in a clearer surgical field and improved outcomes.
Meet Olaf, Our Brave Patient
Olaf, a 9-month-old intact male English bulldog, was presented with a one-month history of mild to moderate bleeding from the sheath and occasional tenesmus without urine production. Physical examination revealed a characteristic urethral prolapse—a small, deep red mass protruding from the penis’s distal end.
Safely Navigating Anesthesia
Before the procedure, Olaf underwent a thorough examination, including a complete blood count and chemistry panel, which came back normal. Anesthesia was induced using propofol, while sevoflurane in oxygen was administered to maintain general anesthesia. To ensure a pain-free procedure, Olaf received buprenorphine and carprofen.
The Power of CO2 Laser Technology
During the procedure, a 20-watt Aesculight surgical CO2 laser was utilized. This state-of-the-art equipment, with its flexible hollow waveguide and tipless handpiece, provided precise control. The laser was set at 8 to 10 watts continuous wave, allowing for minimal tissue damage while effectively controlling intraoperative hemorrhage.
A Technique That Ensures Success
Olaf was placed in dorsal recumbency, and the penis was carefully cleaned with dilute chlorhexidine. To facilitate laser incision, splinter forceps were used to create tension. The surgery began on the ventral surface, with a small incision made at the base of the prolapse. The laser was directed at a 90-degree angle towards the targeted tissue at all times. To prevent retraction, the urethra was sutured to the proximal penile tissue using 4-0 Monocryl sutures. This technique was repeated until the entire prolapsed tissue was removed.
Postoperative Care for a Speedy Recovery
Following the procedure, Olaf was sent home with a prescription for carprofen to manage inflammation and pain. During the first week, his activity was restricted to aid healing. Mild bleeding may occur initially due to excitement and partial erections, so minimizing vigorous activity is recommended. To prevent interference with the surgical site, a protective collar should be worn, and sutures are typically removed 14 days after the surgery.
The Advantages of CO2 Laser Correction
At our clinic, we exclusively use the Aesculight CO2 laser for urethral prolapse corrections. Compared to traditional scalpel surgery, the CO2 laser offers several unique benefits. The laser’s efficiency in achieving hemostasis is unparalleled, especially in this highly vascularized area. Additionally, the absence of a tourniquet makes the surgery less traumatic for penile tissues.
With the advent of CO2 laser technology, the treatment of urethral prolapse has taken a significant stride forward. By utilizing the precise nature of the CO2 laser, veterinarians can achieve optimal results with minimal tissue damage. At Katten TrimSalon, we are committed to providing the best care for your pets, and our use of CO2 laser technology is a testament to our dedication to their well-being.
This article was brought to you by Katten TrimSalon, where compassionate care meets cutting-edge technology.