Akademik Veri Yönetim Sistemi
Scivac, Rimini, İtalya, 23 - 25 Mayıs 2025, ss.60, (Özet Bildiri)
Introduction
A cystocele is the prolapse or herniation of the urinary bladder into the vagina. In humans, it is classified as paravaginal, transverse, central, or mixed, depending on the site of disruption in the pubocervical fascia. This condition results from a loss of integrity in the pubocervical fascia, which provides hammock-like support to the bladder.
In dogs, the urinary bladder is stabilized by ligaments that attach it to the lateral pelvic wall and the ventral abdominal wall. These ligaments consist of double-layered peritoneum, interspersed with blood vessels, nerves, lymphatics, adipose tissue, as well as the ureters, ducts, and remnants of embryonic structures. The middle ligament of the bladder extends from its ventral surface to the pelvic symphysis and the midventral abdominal wall, reaching cranially up to the umbilicus. In female dogs, this ligament terminates near the vaginovestibular junction. Additionally, the lateral ligaments of the bladder anchor its lateral surfaces to the lateral pelvic wall, ensuring structural stability (1).
Elective cesarean delivery may be indicated for various reasons, including a history of dystocia, breeds predisposed to dystocia (e.g., bulldogs), the economic or genetic value of the dam and litter, and logistical considerations. To minimize the risk of neonatal mortality due to underdeveloped respiratory function, elective cesarean sections should be performed as close to full term as possible. The gestation period in canines is generally consistent and predictable (2).
The decision to perform an emergency cesarean section is influenced by several. After evaluating the dam for potential complications related to dystocia (e.g., dehydration, hypoglycemia, hypocalcemia, and hemorrhage), it is crucial to assess fetal heart rates (HR) using ultrasonography (US) or fetal Doppler. Persistent fetal distress, indicated by a consistently low fetal HR of <180 bpm, suggests that continuing medical management for vaginal delivery may further jeopardize the fetus(es). Once the decision to proceed with surgery is made, emergency cesarean should be performed without delay, as further postponement could compromise the health of both the dam and any remaining fetuses (3).
Description of the case
This case report presents a 3-year-old Belgian Malinois in which a prolapsed urinary bladder occurred during labor, resulting in the inability to deliver normally and necessitating a cesarean section. The 3-year-old Belgian Malinois was brought to the Obstetrics and Gynecology Clinic of Ankara University Faculty of Veterinary Medicine on November 27, 2023, following abdominal contractions and vaginal discharge that started on November 26, 2023. Several hours after the onset of abdominal contractions, the owner noticed swelling in the perianal region, between the anus and vulvar lips. Despite this, the dog was unable to deliver normally for more than 12 hours, and no fetuses were expelled. Upon general examination at our clinic, the dog’s weight was measured at 27 kg, and the body temperature was recorded as 38.5°C.
Physical examination and ultrasonography (USG) of the perianal area revealed that the urinary bladder was prolapsed and not in its natural anatomical position within the abdominal cavity. Abdominal USG measurements of the fetal head diameter indicated that the head circumference of the fetus was 3.56 cm, with a fetal heart rate of 202 bpm, suggesting an average gestational age of 63 days. The fetal findings on USG were consistent with the anamnesis. Based on these findings, a cesarean section was decided.
The dog was promptly prepared for surgery, during which 13 puppies were delivered. The prolapsed urinary bladder was repositioned into its natural anatomical position during the surgery and was fixed to the abdominal wall. The puppies were transferred to the resuscitation unit for neonatal care. Of the 13 puppies, 12 showed healthy signs after resuscitation, while 1 puppy was stillborn.
Conclusions
Prolapse of the urinary bladder is a relatively uncommon condition in animals. Specifically, the cystocele that occurred during labor prevented normal delivery. However, following thorough examinations, a cesarean section was performed in conjunction with the fixation of the urinary bladder to the abdominal wall. The intervention was carried out without causing any deterioration in the general condition of the dam and the puppies. Postoperative examinations indicated that the dog was in good health and the cystocele has not recurred.