Evaluation Of Uretero Jejunocolostomy For Urinary Diversion In The Dog
By: Aneeta Hussain | Dr. Mazhar Iqbal.
Contributor(s): Dr. Muhammad | Dr. Muhammad Arif Khan | Faculty of Veterinary Sciences.
Material type: BookPublisher: 1995Subject(s): Department of Clinical Medicine & SurgeryDDC classification: 0423,T Dissertation note: Urinary diversion is the procedure adopted for urine expulsion in the most natural way, in the absence of the urinary bladder. In the beginning of the twentieth century many surgeons of human side as well as veterinarians used intestines for performing urinary diversion. They adopted many methods for this purpose but only a few were found to be successful. These procedures were used to relieve the animal from malignant bladder carcinomas, severe damage of bladder and urethra during accidents, and extrophy of urinary bladder etc. These diseases mostly cause urinary discomfort, incontinence of urine and painless heamaturia and cystectomy becomes a necessity. During this study fifteen healthy dogs of either sex were used. Laparotormy was performed under aseptic precautions. The small intestine was exteriorized through. the incision and the terminal portion of jejunum was identified. A 6-8 cm portion of the jejunurn was selected and milked to clear it of from the feacal materials. This portion was isolated from rest of the intestinal tract with the Doyen's intestinal clamps and was cut off with its mesenteric blood supply remaining intact. The continuity of the small bowel was restored by end to end anastomosis. The vent in mesentery was closed by simple continuous sutures. The isolated Jejunal segment was wrapped in a piece of gauze soaked in normal saline. The urinary bladder was emptied in females by gentle digital pressure and in males by mean of a disposable syringe. The ureters were amputated obliquely down to the trigone area and bladder was excised. Afterwards one end of the Jejunal segment was closed by lambert sutures. A small hole was created on the right side at the upper third portion which cut through the first three layers. From this hole a 2 cm long submucosal tunnel was created going towards the open end of the segment. The cut end of the ureter was sutured to the mucosa of the Jejunal segment using 3/o prolyene simple interrupted sutures. On the left side of the segment the other ureter was implanted similarly. A longitudinal incision equal to the diameter of jejunal segment was made at the antimesenteric border of the distal portion of colon. The open end of jejunal segment was implanted here using 3/0 chromic catgut via side to end anastomosis with simple I nierrupted crushing sutures, thus creating an intestinal bladder. Finally the abdomen was closed in routine manner. It was concluded on the basis of this study that: 1. Viable segment of small bowel with blood and nerve supply intact can be used as a bladder. 2. Voiding occurs in the most natural possible way without any need of an external reservoir. 3. There was no ascending infection, so kidneys remained normal. 4. Use of antibiotics for rest of the life was not needed. The successful attempt of making a new bladder strengthened the belief in cases where there was no other way of saving the animal's life except surgical intervention. So the veterinarian should involve himself with the core of his heart in the operative procedure with the aim of achieving good results. Whether he loses or gains, he must have a satisfaction of being loyal to his profession.Item type | Current location | Collection | Call number | Status | Date due | Barcode | Item holds |
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Thesis | UVAS Library Thesis Section | Veterinary Science | 0423,T (Browse shelf) | Available | 0423,T |
Urinary diversion is the procedure adopted for urine expulsion in the most natural way, in the absence of the urinary bladder. In the beginning of the twentieth century many surgeons of human side as well as veterinarians used intestines for performing urinary diversion. They adopted many methods for this purpose but only a few were found to be successful. These procedures were used to relieve the animal from malignant bladder carcinomas, severe damage of bladder and urethra during accidents, and extrophy of urinary bladder etc. These diseases mostly cause urinary discomfort, incontinence of urine and painless heamaturia and cystectomy becomes a necessity.
During this study fifteen healthy dogs of either sex were used. Laparotormy was performed under aseptic precautions. The small intestine was exteriorized through. the incision and the terminal portion of jejunum was identified. A 6-8 cm portion of the jejunurn was selected and milked to clear it of from the feacal materials. This portion was isolated from rest of the intestinal tract with the Doyen's intestinal clamps and was cut off with its mesenteric blood supply remaining intact. The continuity of the small bowel was restored by end to end anastomosis. The vent in mesentery was closed by simple continuous sutures. The isolated Jejunal segment was wrapped in a piece of gauze soaked in normal saline.
The urinary bladder was emptied in females by gentle digital pressure and in males by mean of a disposable syringe. The ureters were amputated obliquely down to the trigone area and bladder was excised. Afterwards one end of the Jejunal segment was closed by lambert sutures. A small hole was created on the right side at the upper third portion which cut through the first three layers. From this hole a 2 cm long submucosal tunnel was created going towards the open end of the segment. The cut end of the ureter was sutured to the mucosa of the Jejunal segment using 3/o prolyene simple interrupted sutures. On the left side of the segment the other ureter was implanted similarly.
A longitudinal incision equal to the diameter of jejunal segment was made at the antimesenteric border of the distal portion of colon. The open end of jejunal segment was implanted here using 3/0 chromic catgut via side to end anastomosis with simple I nierrupted crushing sutures, thus creating an intestinal bladder. Finally the abdomen was closed in routine manner. It was concluded on the basis of this study that:
1. Viable segment of small bowel with blood and nerve supply intact can be used as a bladder.
2. Voiding occurs in the most natural possible way without any need of an external reservoir.
3. There was no ascending infection, so kidneys remained normal.
4. Use of antibiotics for rest of the life was not needed.
The successful attempt of making a new bladder strengthened the belief in cases where there was no other way of saving the animal's life except surgical intervention. So the veterinarian should involve himself with the core of his heart in the operative procedure with the aim of achieving good results. Whether he loses or gains, he must have a satisfaction of being loyal to his profession.
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