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The male urogenital system
/content/chapter/10.22233/9781910443248.chap16
The male urogenital system
- Author: Richard A.S. White
- From: BSAVA Manual of Canine and Feline Abdominal Surgery
- Item: Chapter 16, pp 307 - 332
- DOI: 10.22233/9781910443248.16
- Copyright: © 2015 British Small Animal Veterinary Association
- Publication Date: November 2015
Abstract
The testes are paired ovoid organs normally located in the scrotum and are responsible for producing both the male hormone (testosterone) and the male gametes (sperm). This chapter considers the anatomy and conditions of the testicle, the prostate gland and the penis and prepuce as well as urethrostomy procedures. Operative techniques: Canine castration; Prostatic abscess management (intracapsular prostatic omentalization); Partial resection and omentalization for discrete prostatic cysts; Canine penile amputation; Canine scrotal urethrostomy; Feline perineal urethrostomy (PU); Prepubic urethrostomy (PPU).
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Figures
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16.1
Incision in the left inguinal region of a cat. (a) The retained left testicle is located under the inguinal fat. (b) Traction on the testicle reveals the spermatic cord and castration is performed routinely.
© 2015 British Small Animal Veterinary Association
(Courtesy of J. Niles)
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16.1
Incision in the left inguinal region of a cat. (a) The retained left testicle is located under the inguinal fat. (b) Traction on the testicle reveals the spermatic cord and castration is performed routinely.
(Courtesy of J. Niles)
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16.2
Vascular supply to the male urogenital tract. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2015 British Small Animal Veterinary Association
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16.2
Vascular supply to the male urogenital tract. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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16.3
(a) Urethral prolapse in a young Bulldog. (b) A urethral catheter and Rummel tourniquet (Penrose drain) have been placed. (c) The prolapsed urethral mucosa is resected. (d) The urethral mucosa is sutured to the penile mucosa with simple interrupted absorbable sutures. © 2015 British Small Animal Veterinary Association
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16.3
(a) Urethral prolapse in a young Bulldog. (b) A urethral catheter and Rummel tourniquet (Penrose drain) have been placed. (c) The prolapsed urethral mucosa is resected. (d) The urethral mucosa is sutured to the penile mucosa with simple interrupted absorbable sutures.
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The testicle is exteriorized by incising the spermatic fascia but leaving the parietal vaginal tunic intact.
The testicle is exteriorized by incising the spermatic fascia but leaving the parietal vaginal tunic intact. © 2015 British Small Animal Veterinary Association
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The testicle is exteriorized by incising the spermatic fascia but leaving the parietal vaginal tunic intact.
The testicle is exteriorized by incising the spermatic fascia but leaving the parietal vaginal tunic intact.
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The testicle is further exteriorized by breaking the dense connective tissue between the tail of the epididymis and the scrotal wall (scrotal ligament).
The testicle is further exteriorized by breaking the dense connective tissue between the tail of the epididymis and the scrotal wall (scrotal ligament). © 2015 British Small Animal Veterinary Association
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The testicle is further exteriorized by breaking the dense connective tissue between the tail of the epididymis and the scrotal wall (scrotal ligament).
The testicle is further exteriorized by breaking the dense connective tissue between the tail of the epididymis and the scrotal wall (scrotal ligament).
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Adherent adipose tissue is removed from the parietal tunic by brushing from the testicle downwards with a moist surgical swab.
Adherent adipose tissue is removed from the parietal tunic by brushing from the testicle downwards with a moist surgical swab. © 2015 British Small Animal Veterinary Association
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Adherent adipose tissue is removed from the parietal tunic by brushing from the testicle downwards with a moist surgical swab.
Adherent adipose tissue is removed from the parietal tunic by brushing from the testicle downwards with a moist surgical swab.
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The point at which the spermatic cord is to be ligated may be crushed in artery forceps prior to the placement of a transfixing figure-of-eight ligature through the non-vascular component of the cord.
The point at which the spermatic cord is to be ligated may be crushed in artery forceps prior to the placement of a transfixing figure-of-eight ligature through the non-vascular component of the cord. © 2015 British Small Animal Veterinary Association
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The point at which the spermatic cord is to be ligated may be crushed in artery forceps prior to the placement of a transfixing figure-of-eight ligature through the non-vascular component of the cord.
The point at which the spermatic cord is to be ligated may be crushed in artery forceps prior to the placement of a transfixing figure-of-eight ligature through the non-vascular component of the cord.
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Sever the cord immediately above the ligature.
Sever the cord immediately above the ligature. © 2015 British Small Animal Veterinary Association
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Sever the cord immediately above the ligature.
Sever the cord immediately above the ligature.
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Grasp and incise the parietal vaginal tunic to allow retraction of the testicle from within the tunics.
Grasp and incise the parietal vaginal tunic to allow retraction of the testicle from within the tunics. © 2015 British Small Animal Veterinary Association
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Grasp and incise the parietal vaginal tunic to allow retraction of the testicle from within the tunics.
Grasp and incise the parietal vaginal tunic to allow retraction of the testicle from within the tunics.
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Separate the spermatic cord from the tunics and cremaster muscle.
Separate the spermatic cord from the tunics and cremaster muscle. © 2015 British Small Animal Veterinary Association
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Separate the spermatic cord from the tunics and cremaster muscle.
Separate the spermatic cord from the tunics and cremaster muscle.
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Ligate the cremaster muscle and tunics separately; transect immediately above the ligature.
Ligate the cremaster muscle and tunics separately; transect immediately above the ligature. © 2015 British Small Animal Veterinary Association
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Ligate the cremaster muscle and tunics separately; transect immediately above the ligature.
Ligate the cremaster muscle and tunics separately; transect immediately above the ligature.
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Exposure of the prostate gland via caudal laparotomy.
Exposure of the prostate gland via caudal laparotomy. © 2015 British Small Animal Veterinary Association
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Exposure of the prostate gland via caudal laparotomy.
Exposure of the prostate gland via caudal laparotomy.
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Pus draining from lateral stab incision in prostate gland.
Pus draining from lateral stab incision in prostate gland. © 2015 British Small Animal Veterinary Association
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Pus draining from lateral stab incision in prostate gland.
Pus draining from lateral stab incision in prostate gland.
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‘Window’ created in lateral aspect of the prostatic abscess.
‘Window’ created in lateral aspect of the prostatic abscess. © 2015 British Small Animal Veterinary Association
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‘Window’ created in lateral aspect of the prostatic abscess.
‘Window’ created in lateral aspect of the prostatic abscess.
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Digital exploration of the abscess cavities.
Digital exploration of the abscess cavities. © 2015 British Small Animal Veterinary Association
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Digital exploration of the abscess cavities.
Digital exploration of the abscess cavities.
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Forceps drawing omentum into ventral abscess cavity.
Forceps drawing omentum into ventral abscess cavity. © 2015 British Small Animal Veterinary Association
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Forceps drawing omentum into ventral abscess cavity.
Forceps drawing omentum into ventral abscess cavity.
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Omentum in ventral abscess cavity before packing into dorsal cavity.
Omentum in ventral abscess cavity before packing into dorsal cavity. © 2015 British Small Animal Veterinary Association
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Omentum in ventral abscess cavity before packing into dorsal cavity.
Omentum in ventral abscess cavity before packing into dorsal cavity.
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The paraprostatic cyst (arrowed) is exteriorized and the abdomen packed off with swabs.
The paraprostatic cyst (arrowed) is exteriorized and the abdomen packed off with swabs. © 2015 British Small Animal Veterinary Association
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The paraprostatic cyst (arrowed) is exteriorized and the abdomen packed off with swabs.
The paraprostatic cyst (arrowed) is exteriorized and the abdomen packed off with swabs.
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A single stab is made into the cyst and its contents are aspirated.
A single stab is made into the cyst and its contents are aspirated. © 2015 British Small Animal Veterinary Association
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A single stab is made into the cyst and its contents are aspirated.
A single stab is made into the cyst and its contents are aspirated.
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The majority of the cyst wall is resected.
The majority of the cyst wall is resected. © 2015 British Small Animal Veterinary Association
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The majority of the cyst wall is resected.
The majority of the cyst wall is resected.
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Carcinoma of penile glans.
Carcinoma of penile glans. © 2015 British Small Animal Veterinary Association
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Carcinoma of penile glans.
Carcinoma of penile glans.
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Extrusion of the penis with tourniquet around the base.
Extrusion of the penis with tourniquet around the base. © 2015 British Small Animal Veterinary Association
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Extrusion of the penis with tourniquet around the base.
Extrusion of the penis with tourniquet around the base.
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Incision in penile mucosa.
Incision in penile mucosa. © 2015 British Small Animal Veterinary Association
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Incision in penile mucosa.
Incision in penile mucosa.
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Separation of the urethra from the os penis.
Separation of the urethra from the os penis. © 2015 British Small Animal Veterinary Association
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Separation of the urethra from the os penis.
Separation of the urethra from the os penis.
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Amputation of the penis, leaving an extended section of urethra.
Amputation of the penis, leaving an extended section of urethra. © 2015 British Small Animal Veterinary Association
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Amputation of the penis, leaving an extended section of urethra.
Amputation of the penis, leaving an extended section of urethra.
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Oversewing the cavernous tissue to limit bleeding.
Oversewing the cavernous tissue to limit bleeding. © 2015 British Small Animal Veterinary Association
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Oversewing the cavernous tissue to limit bleeding.
Oversewing the cavernous tissue to limit bleeding.
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Spatulation of the reflected mucosa over the end of the amputated penis.
Spatulation of the reflected mucosa over the end of the amputated penis. © 2015 British Small Animal Veterinary Association
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Spatulation of the reflected mucosa over the end of the amputated penis.
Spatulation of the reflected mucosa over the end of the amputated penis.
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Completed urethral repair.
Completed urethral repair. © 2015 British Small Animal Veterinary Association
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Completed urethral repair.
Completed urethral repair.
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Bleeding following removal of tourniquet.
Bleeding following removal of tourniquet. © 2015 British Small Animal Veterinary Association
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Bleeding following removal of tourniquet.
Bleeding following removal of tourniquet.
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Patient positioned for scrotal urethrostomy.
Patient positioned for scrotal urethrostomy. © 2015 British Small Animal Veterinary Association
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Patient positioned for scrotal urethrostomy.
Patient positioned for scrotal urethrostomy.
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Castration with scrotal ablation.
Castration with scrotal ablation. © 2015 British Small Animal Veterinary Association
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Castration with scrotal ablation.
Castration with scrotal ablation.
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The retractor penis muscle is identified and displaced laterally to expose the urethra.
The retractor penis muscle is identified and displaced laterally to expose the urethra. © 2015 British Small Animal Veterinary Association
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The retractor penis muscle is identified and displaced laterally to expose the urethra.
The retractor penis muscle is identified and displaced laterally to expose the urethra.
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The urethra is incised longitudinally with a No. 11 scalpel blade; the urethral mucosa is identified.
The urethra is incised longitudinally with a No. 11 scalpel blade; the urethral mucosa is identified. © 2015 British Small Animal Veterinary Association
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The urethra is incised longitudinally with a No. 11 scalpel blade; the urethral mucosa is identified.
The urethra is incised longitudinally with a No. 11 scalpel blade; the urethral mucosa is identified.
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Monofilament, non-absorbable suture material (polypropylene) is used to suture the urethrostomy. A swaged-on taper cut needle should be used to minimize the size of the needle tract. The urethrostomy can be sutured using either a simple interrupted or a simple continuous pattern. A simple continuous pattern results in accurate apposition of the urethral mucosa to the skin and helps to achieve haemostasis. If the cranial aspect of the skin incision extends beyond the urethral incision, it should be closed with simple interrupted sutures. The needle should be driven from the urethral mucosa to the skin for best apposition. Each suture should comprise three tissue bites: the urethral mucosa; a 2–3 mm bite of the fibrous tunica albuginea; and a split-thickness bite of the skin.
Monofilament, non-absorbable suture material (polypropylene) is used to suture the urethrostomy. A swaged-on taper cut needle should be used to minimize the size of the needle tract. The urethrostomy can be sutured using either a simple interrupted or a simple continuous pattern. A simple continuous pattern results in accurate apposition of the urethral mucosa to the skin and helps to achieve haemostasis. If the cranial aspect of the skin incision extends beyond the urethral incision, it should be closed with simple interrupted sutures. The needle should be driven from the urethral mucosa to the skin for best apposition. Each suture should comprise three tissue bites: the urethral mucosa; a 2–3 mm bite of the fibrous tunica albuginea; and a split-thickness bite of the skin. © 2015 British Small Animal Veterinary Association
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Monofilament, non-absorbable suture material (polypropylene) is used to suture the urethrostomy. A swaged-on taper cut needle should be used to minimize the size of the needle tract. The urethrostomy can be sutured using either a simple interrupted or a simple continuous pattern. A simple continuous pattern results in accurate apposition of the urethral mucosa to the skin and helps to achieve haemostasis. If the cranial aspect of the skin incision extends beyond the urethral incision, it should be closed with simple interrupted sutures. The needle should be driven from the urethral mucosa to the skin for best apposition. Each suture should comprise three tissue bites: the urethral mucosa; a 2–3 mm bite of the fibrous tunica albuginea; and a split-thickness bite of the skin.
Monofilament, non-absorbable suture material (polypropylene) is used to suture the urethrostomy. A swaged-on taper cut needle should be used to minimize the size of the needle tract. The urethrostomy can be sutured using either a simple interrupted or a simple continuous pattern. A simple continuous pattern results in accurate apposition of the urethral mucosa to the skin and helps to achieve haemostasis. If the cranial aspect of the skin incision extends beyond the urethral incision, it should be closed with simple interrupted sutures. The needle should be driven from the urethral mucosa to the skin for best apposition. Each suture should comprise three tissue bites: the urethral mucosa; a 2–3 mm bite of the fibrous tunica albuginea; and a split-thickness bite of the skin.
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The proximal urethra is catheterized.
The proximal urethra is catheterized. © 2015 British Small Animal Veterinary Association
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The proximal urethra is catheterized.
The proximal urethra is catheterized.
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Completed scrotal urethrostomy.
Completed scrotal urethrostomy. © 2015 British Small Animal Veterinary Association
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Completed scrotal urethrostomy.
Completed scrotal urethrostomy.
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Incision surrounding the scrotum.
Incision surrounding the scrotum. © 2015 British Small Animal Veterinary Association
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Incision surrounding the scrotum.
Incision surrounding the scrotum.
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Dissection and dorsal reflection of the penis.
Dissection and dorsal reflection of the penis. © 2015 British Small Animal Veterinary Association
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Dissection and dorsal reflection of the penis.
Dissection and dorsal reflection of the penis.
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Incision of the ischiocavernosus muscle.
Incision of the ischiocavernosus muscle. © 2015 British Small Animal Veterinary Association
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Incision of the ischiocavernosus muscle.
Incision of the ischiocavernosus muscle.
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Resection of the ischiocavernosus muscle.
Resection of the ischiocavernosus muscle. © 2015 British Small Animal Veterinary Association
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Resection of the ischiocavernosus muscle.
Resection of the ischiocavernosus muscle.
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Resection of the retractor penis muscle.
Resection of the retractor penis muscle. © 2015 British Small Animal Veterinary Association
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Resection of the retractor penis muscle.
Resection of the retractor penis muscle.
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Exposure of penile urethra with urolith and localized cellulitis.
Exposure of penile urethra with urolith and localized cellulitis. © 2015 British Small Animal Veterinary Association
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Exposure of penile urethra with urolith and localized cellulitis.
Exposure of penile urethra with urolith and localized cellulitis.
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Spatulation of the urethral mucosa and cutaneous suturing.
Spatulation of the urethral mucosa and cutaneous suturing. © 2015 British Small Animal Veterinary Association
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Spatulation of the urethral mucosa and cutaneous suturing.
Spatulation of the urethral mucosa and cutaneous suturing.
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Urethral stoma after amputation of the penile stoma.
Urethral stoma after amputation of the penile stoma. © 2015 British Small Animal Veterinary Association
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Urethral stoma after amputation of the penile stoma.
Urethral stoma after amputation of the penile stoma.
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Position of the prepubic incision.
Position of the prepubic incision. © 2015 British Small Animal Veterinary Association
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Position of the prepubic incision.
Position of the prepubic incision.
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Dissection of the bladder neck and urethra.
Dissection of the bladder neck and urethra. © 2015 British Small Animal Veterinary Association
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Dissection of the bladder neck and urethra.
Dissection of the bladder neck and urethra.
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Elevation of the bladder neck and urethra.
Elevation of the bladder neck and urethra. © 2015 British Small Animal Veterinary Association
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Elevation of the bladder neck and urethra.
Elevation of the bladder neck and urethra.
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Exteriorization of the resected urethra.
Exteriorization of the resected urethra. © 2015 British Small Animal Veterinary Association
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Exteriorization of the resected urethra.
Exteriorization of the resected urethra.
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Resected urethra anchored in the laparotomy repair.
Resected urethra anchored in the laparotomy repair. © 2015 British Small Animal Veterinary Association
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Resected urethra anchored in the laparotomy repair.
Resected urethra anchored in the laparotomy repair.
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Complete urethral stoma.
Complete urethral stoma. © 2015 British Small Animal Veterinary Association
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Complete urethral stoma.
Complete urethral stoma.