Repair of urinary bladder rupture through a urethrotomy and urethral sphincterotomy in four postpartum mares.
Authors: Higuchi Tohru, Nanao Yuki, Senba Hiroyuki
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Urinary Bladder Rupture Repair in Postpartum Mares Bladder rupture represents a life-threatening complication of parturition in mares, typically necessitating emergency surgical intervention; this 2002 case series describes an innovative standing surgical approach using urethrotomy and urethral sphincterotomy to access and repair the defect without general anaesthesia. Four postpartum Thoroughbreds presenting with characteristic clinical signs—depression, inappetence, shock, dehydration, azotemia and electrolyte disturbances—underwent repair via controlled eversion of the bladder into the vagina through a urethral incision that included sphincterotomy, with the defect closed using single-layer absorbable suture in a continuous pattern. Despite the severity of metabolic derangement evident in all cases, intensive supportive therapy combined with surgical repair proved successful in all four mares, with complete recovery of renal and electrolyte function and return to reproductive soundness. The technique offers considerable advantages for field practitioners and smaller equine facilities where general anaesthesia capability may be limited, though the procedure demands precise anatomical knowledge and careful patient selection based on tear location and individual circumstances. This approach merits consideration as an alternative to conventional exploratory laparotomy, particularly when standing surgery is feasible and appropriate perioperative management can be maintained.
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Practical Takeaways
- •Recognize postpartum depression, inappetence, shock, and azotemia as potential indicators of bladder rupture requiring urgent surgical intervention
- •Bladder rupture can be successfully managed through standing surgical repair via urethrotomy approach, offering a practical alternative to standard colic surgery positioning
- •Aggressive supportive therapy addressing electrolyte and metabolic abnormalities is essential alongside surgical repair for successful outcomes
Key Findings
- •Bladder rupture in postpartum mares presented with depression, inappetence, shock, dehydration, azotemia, and electrolyte abnormalities
- •Successful bladder repair achieved through urethrotomy with urethral sphincterotomy and single-layer continuous suture closure
- •All 4 mares survived surgery, with complete resolution of metabolic derangements following supportive medical therapy
- •All treated mares subsequently conceived and produced additional foals without further complications