Single-stage reconstruction of third-degree perineal lacerations in horses under general anesthesia: Utrecht repair method.
Authors: Frietman Sjoerd K, Compagnie Ellen, Stout Tom A E, Jonker F Herman, Ter Braake Frerik
Journal: Veterinary surgery : VS
Summary
Third-degree perineal lacerations represent a significant complication in mares, typically requiring complex surgical reconstruction to restore anatomical integrity and preserve fertility and athletic function. The Utrecht repair method (URM) offers a single-stage alternative to traditional multi-stage repairs, which the authors evaluated retrospectively across 20 mares over an extended follow-up period (mean 9 years). Successful reconstruction of the rectovestibular shelf was achieved in 18 of 20 cases, with only two mares requiring a second procedure to address minor rectovestibular fistulae; whilst postoperative complications occurred in 13 mares, these were predominantly minor and unrelated to the surgical technique itself, including mild myositis, transient rectal obstipation, and partial perineal dehiscence. Of the seven mares subsequently bred, six conceived and five foaled without recurrence, whilst nine of thirteen mares resumed ridden work at various levels, demonstrating functional and reproductive success. The URM's single-stage approach, supported by standardised perioperative management protocols, represents a viable option for practitioners managing third-degree perineal trauma, offering comparable outcomes to multi-stage techniques with the logistical advantage of completing reconstruction in a single anaesthetic event.
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Practical Takeaways
- •The Utrecht repair method is a reliable single-stage surgical option for third-degree perineal lacerations with 90% success rate avoiding need for staged repairs
- •Mares treated with this technique can return to breeding and athletic use; 71% of bred mares carried pregnancies successfully without recurrence
- •Standardized perioperative protocols including fasting, refeeding, and selective use of gastric support are important for managing postoperative complications
Key Findings
- •Single-stage Utrecht repair method successfully reconstructed the rectovestibular shelf in 18 of 20 mares (90%)
- •Two mares developed small rectovestibular fistulas requiring second surgery, both repaired successfully
- •Six of seven mares subsequently bred became pregnant with five of six foaling without TDPL recurrence
- •Nine of 13 mares returned to riding at various levels with mean follow-up of 9 years