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The female reproductive system

image of The female reproductive system
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Abstract

Elective neutering of female dogs and cats is one of the commonest surgeries performed in veterinary practice. Over the last decade, sterilization techniques in the bitch have advanced with the introduction of laparoscopic techniques and the acceptance of both ovariectomy and ovariohysterectomy for routine neutering. This chapter addresses anatomy and surgical procedures, broken down into uterus; ovaries; vagina, vestibule and vulva; and external genitalia. Practical tips are highlighted throughout. Canine ovariohysterectomy; Canine ovariectomy; Feline ovariohysterectomy; Caesarian section; Episioplasty; Episiotomy.

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Figures

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17.1 The anatomy of the female reproductive system in the bitch. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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17.2 Different knots that are suitable for ovarian pedicle ligation. (a) Sliding knot. (b) Modified transfixing ligature. (c) Single/double other side knot. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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17.3 Laparoscopic ovariectomy with the ovary suspended to the body wall via an externally placed suture and a vessel-sealing device across the ovarian pedicle.
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17.4 The appearance of the uterus in a 6-year-old Mastiff following bilateral laparoscopic ovariectomy 4 years previously.
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17.5 Postoperative haemorrhage following ovariohysterectomy. Exploratory surgery was required to stop the cervical bleeding.
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17.6 Ovarian granuloma that has resulted in ureteric entrapment, hydronephrosis and flank sinus. The granuloma was resected along with the left kidney and ureter. (Courtesy of P Neath)
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17.7 MR image showing ureteric entrapment by an ovarian granuloma (arrowed) with subsequent hydronephrosis.
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17.8 Flank sinus secondary to an ovarian granuloma in a 3-year-old bitch neutered 3 years previously.
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17.9 Unicornuate uterus as an incidental finding during a cat ovariohysterectomy. The ovary is in the correct position.
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17.10 Closed pyometra in a 9-year-old Boxer. The uterine horns are engorged and friable and require delicate handling to prevent rupture. (Courtesy of J Hall)
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17.11 Uterine horn torsion in a cat.
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17.12 Ovarian cyst as an incidental finding during ovariectomy.
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17.13 Ovarian tumour (carcinoma) in a 6-year-old Collie cross. (Courtesy of J Hall)
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17.14 (a) Vaginal prolapse in a Pug that whelped 2 days previously. (b) Vaginal prolapse post-resection.
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17.15 Vulval squamous cell carcinoma. This tumour was resected with 1 cm surgical margins, resulting in a perineal urethrostomy. Clean surgical margins were achieved. (Courtesy of R Doust)
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17.16 Vulval fold pyoderma in a 6-year-old neutered Newfoundland bitch.
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17.17 Vaginal septum (thick vertical band) approached by an episiotomy.
Image of Ovary retracted whilst suspensory ligament is stretched/ruptured.
Ovary retracted whilst suspensory ligament is stretched/ruptured. Ovary retracted whilst suspensory ligament is stretched/ruptured.
Image of Ovarian pedicle (containing the ovarian artery and vein), with three clamps placed below the ovary. The dashed line shows the level of transection.
Ovarian pedicle (containing the ovarian artery and vein), with three clamps placed below the ovary. The dashed line shows the level of transection. Ovarian pedicle (containing the ovarian artery and vein), with three clamps placed below the ovary. The dashed line shows the level of transection.
Image of Ligature placed and tied in crush mark created by proximal clamp.
Ligature placed and tied in crush mark created by proximal clamp. Ligature placed and tied in crush mark created by proximal clamp.
Image of Broad ligament broken down and ‘bunch’ ligated if vascular.
Broad ligament broken down and ‘bunch’ ligated if vascular. Broad ligament broken down and ‘bunch’ ligated if vascular.
Image of Three clamps applied to uterine body, immediately distal to the cervix (C). Dashed line indicates amputation site.
Three clamps applied to uterine body, immediately distal to the cervix (C). Dashed line indicates amputation site. Three clamps applied to uterine body, immediately distal to the cervix (C). Dashed line indicates amputation site.
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Image of Subcutaneous fat is excised to expose the underlying muscles.
Subcutaneous fat is excised to expose the underlying muscles. Subcutaneous fat is excised to expose the underlying muscles.
Image of Incision through external abdominal oblique, internal abdominal oblique and rectus abdominis muscles, using a No. 15 scalpel blade.
Incision through external abdominal oblique, internal abdominal oblique and rectus abdominis muscles, using a No. 15 scalpel blade. Incision through external abdominal oblique, internal abdominal oblique and rectus abdominis muscles, using a No. 15 scalpel blade.
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Image of Untitled
Image of Untitled
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Image of Episiotomy incision. The dorsoventral incision begins 1–2 cm ventral to the anus and extends to include the dorsal vulvar commissure (arrowed). The incision is continued through the subcutaneous and muscle tissue layers, entering the vaginal wall.
Episiotomy incision. The dorsoventral incision begins 1–2 cm ventral to the anus and extends to include the dorsal vulvar commissure (arrowed). The incision is continued through the subcutaneous and muscle tissue layers, entering the vaginal wall. Episiotomy incision. The dorsoventral incision begins 1–2 cm ventral to the anus and extends to include the dorsal vulvar commissure (arrowed). The incision is continued through the subcutaneous and muscle tissue layers, entering the vaginal wall.

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