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The female reproductive system

image of The female reproductive system
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Abstract

The canine and feline female reproductive tract comprises internal and external genitalia. The ovaries are found close to the caudal poles of the kidneys and are generally ovoid in shape (although this is less consistent if a large follicle or corpus luteum is present). They have a cortex (containing the follicles) and a medulla. The right ovary is often found dorsal to the ascending colon, and the left ovary is located adjacent to the descending colon. The ovaries are enclosed by the ovarian bursae. The uterine tube begins as the funnel-shaped infundibulum adjacent to the ovary and continues as the ampulla then isthmus until the junction with the uterine horn. The course of the uterine tube is tortuous and lies within the wall of the ovarian bursa. The uterus comprises two horns leading into a short body, terminating in a short thick-walled cervix. The uterine wall has three layers;: an outer serosal layer (perimetrium); a muscular layer (myometrium) and an inner mucosal layer (endometrium). The uterus is generally dorsal to the small intestines, with the body lying ventral to the descending colon and dorsal to the bladder. The chapter discusses Normal radiographic appearance; Contrast radiography; Indications; Ultrasonography; Overview of additional imaging modalities; Normal pregnancy; Female reproductive system diseases; and Mammary glands.

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Figures

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18.2 Retrograde positive-contrast study delineating the body and horns of a normal canine uterus. Radiopaque cystoliths are seen ventrally.
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18.3 Retrograde positive-contrast vaginourethrogram of the normal lower genital tract in the bitch.
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18.4 Iatrogenic rupture of the vagina during retrograde vaginourethrography due to occlusion of the urethra by the bulb of the Foley catheter. Filling of vagina evident. Abnormal shape of the cranial vagina, suspected to be due to dissection of the vaginal mucosa through a tear in the muscle layers. No additional filling of bladder noted. Complete vaginal rupture, with dissection of contrast medium into the surrounding tissues. The patient was successfully managed with the placement of an indwelling urinary catheter for a few days.
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18.5 Normal ultrasonographic appearance of the canine ovary.
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18.6 Ultrasonogram of canine ovary during metoestrus. Note the corpus luteum formation.
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18.7 Ultrasonographic appearance of normal canine uterus. Transverse ultrasonogram of the uterine body, demonstrating location between the bladder and descending colon. Longitudinal ultrasonogram of the uterine body showing lack of visible layering or luminal content.
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18.8 Longitudinal ultrasonogram of the canine cervix, which appears as a fusiform hyperechoic structure.
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18.10 Radiographic appearance of normal canine fetal skeletons, with slight flexion of the spine and non-overlapping skull bones.
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18.12 Ultrasonogram of normal canine fetus at about 30 days of gestation. The fetus can be oriented and the eye is seen as an anechoic structure. Colour Doppler ultrasonogram demonstrating blood flow within the fetal heart.
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18.13 Ultrasonogram of the post-partum uterus in the early stage of involution. (Courtesy of A King)
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18.14 Lateral radiograph of the abdomen of an intact bitch, demonstrating a large rounded soft tissue mass in the dorsal mid-abdomen with ventral displacement of intestinal structures. The left renal shadow can be seen superimposed on the mass. An ovarian neoplasm was found at exploratory surgery.
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18.15 Right lateral and VD radiographs of the abdomen of an intact bitch, demonstrating a large soft tissue mass with irregular mineralization in the right mid-abdomen. The mass is causing displacement of the intestines and compression of the cranial pole of the bladder. A teratoma was confirmed on histopathology, and contained hair clumps and sheets of cartilage and foci of bone.
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18.16 Ultrasonograms of cystic changes in the ovary. Two small cystic areas in the ovary. Cyst occupying the entire ovary.
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18.17 Ultrasonograms of the bitch in Figure 18.15 , demonstrating the heterogenous nature of an ovarian teratoma. Cystic areas. Solid tissue with acoustic shadowing.
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18.18 Ultrasonograms of cystic endometrial hyperplasia, demonstrating large cystic areas within the uterine wall and the diffuse nature of disease (both uterine horns are affected).
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18.19 Ultrasonograms demonstrating the appearance of pyometra. Mild dilatation of the uterine horn with echogenic fluid. A transverse view of a loop of jejunum is seen at the right of the image, demonstrating the differing appearance of the walls of the uterus and small intestine. A more dilated uterine horn containing echogenic fluid.
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18.20 Lateral radiographs demonstrating differing degrees of pyometra. Moderate distension of the uterus, with separation of the bladder and descending colon and occupation of the caudoventral abdomen by coiled soft tissue loops. Severely distended loops of uterus occupying the ventral and caudal abdomen, with dorsal displacement of the intestines.
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18.21 Lateral radiograph showing marked gaseous distension of the uterus with faintly visible fetal skeletal structures within the lumen. (Courtesy of the University of Bristol)
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18.22 Stump pyometra. Ultrasonogram showing a hypoechoic moderately defined mass dorsal to the bladder neck. Lateral radiograph of the caudal abdomen showing an ill defined soft tissue mass between the bladder neck and descending colon. (Courtesy of M Sullivan) Lateral radiograph of the caudal abdomen showing a soft tissue mass between the contrast medium-filled bladder and contrast medium-filled rectum. (Courtesy of the University of Bristol)
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18.24 Radiographic appearance of fetal mummification. Note the increased radiopacity of the fetus and the abnormally flexed appearance. (Courtesy of M Sullivan)
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18.25 Lateral positive-contrast retrograde vaginourethrogram showing an ill defined margin to the cranial end of contrast medium column at the interface with the cervix. A cervical neoplasm was found at exploratory surgery.
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18.26 Lateral radiograph following positive-contrast urethrography and pneumovaginography showing vestibulovaginal stenosis. A soft tissue narrowing between the vagina and vestibule is clearly demonstrated by the negative contrast medium.
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18.27 Lateral positive-contrast retrograde study demonstrating vaginal aplasia. Note the lack of contrast medium filling the lower genital tract.
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18.28 Lateral retrograde vaginourethrogram demonstrating irregular margins to the mucosa of the vagina (especially dorsally). This appearance is consistent with vaginitis.
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18.29 Lateral retrograde vaginourethrogram showing corrugated irregular filling of the vagina, which is overlong. This appearance is consistent with vaginal hyperplasia.
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18.30 Lateral retrograde vaginourethrogram showing a large ventral rounded filling defect in the caudal vagina. A vaginal mass was confirmed on vaginoscopy.
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18.31 Lateral radiograph of the abdomen of an intact bitch, showing dilated loops of uterus occupying the caudoventral abdomen (pyometra was confirmed at exploratory surgery) and multiple mineralized opacities ventral to the abdominal wall. These were confirmed as multiple mineralized mammary gland tumours (arrowheads).

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