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Vaginectomy is the surgical procedure to remove the vagina of a female dog. Vaginectomy may be necessary to resect a malignant or multiple vaginal tumors, with the aim of removing the cancer and extending life.
Vaginal polyps in intact female dogs are the most common type of vaginal growth, and less aggressive. These are often amenable to removal via the lesser procedure of an episiotomy, along with ovariohysterectomy to prevent recurrence.
However, the more aggressive surgery of vaginectomy is necessary for large masses or those suspected to be malignant. The surgery is complex and intricate, involving both an approach from inside the abdomen and from the vestibule or exterior of the vagina. Whilst no special equipment is needed and so, in theory, can be performed in first opinion practice, the tricky nature of the procedure means referral to a specialist surgeon is appropriate in most cases.
The patient is carefully assessed prior to surgery, for the size, shape, and extent of the vaginal mass. Where less invasive options are not appropriate, referral for vaginectomy may be required.
The patient is given a general anesthetic and the hair clipped from the abdomen and the perineal region. The dog is placed on her back and the surgeon makes an incision in the caudal part of the abdomen.
An ovariohysterectomy is performed, and the attachments of the cervix and vagina to the body wall are dissected. The surgeon then converts to an approach via the perineal region and the vestibule of the vagina, in order to made an incision which frees up the vagina. The incision is carefully 'chased' around the circumference of the vaginal stump, ligating blood vessels as it goes. The reproductive tract include vagina is then removed from the abdomen.
Extreme care is taken not to damage the ureters or urethra, and leave a patent opening for the urethra to drain into the cranial vagina stump.
The abdomen is then closed and the patient woken.
Malignant vaginal tumors are relatively rare in the female dog. However, those patients taken to surgery did well, and in most cases lived in excess of one year following surgery. This is excellent considering most cases were exhibiting physical signs prior to surgery, such as difficulty urinating or bleeding from the vagina.
The more common presentation of a benign mass or a vaginal polyp, also needs surgical resection. However, many benign masses grow from a pedicle or stalk, which combined with adequate access to the stalk via an episiotomy, means this less invasive option is preferred.
Comprehensive pain relief is crucial before, during, and after vaginectomy. Typically, drugs from the opioid family are desired in the immediate perioperative period, with the option to wean down to nonsteroidal anti-inflammatories as the days pass.
The surgical incisions must be protected from contamination, thus the dog must wear a cone or T-shirt to prevent licking. Exercise should be severely restricted for at least two weeks, until the skin sutures are removed. After that gentle exercise is appropriate for around one month postoperatively.
Whilst a routine spay operation cost around $200 to $400, expect a vaginectomy with ovariohysterectomy to cost upwards from $1,500 to $3,000. This is because of the delicate nature of the surgery, which takes a considerable amount of time and the skill of a surgeon who has undergone additional surgical training.
The aim of vaginectomy is to remove a malignant tumor with wide surgical margins. Successful surgery significantly improves the quality of life and life expectancy of the patient.
In less skilled hands there could be potential complications with the urethra (through which urine passes from the bladder.) There is also the potential for wound breakdown which could lead to peritonitis. Both of these complications are serious and could lead to euthanasia.
Although major surgery, the recovery time is similar to that of a mature female dog undergoing ovariohysterectomy (spay) and so should not be discounted as an option in appropriate cases.
Vaginal tumors, especially polyps, are much more common in intact female dogs who still have their ovaries and womb. Thus, ovariohysterectomy is an important tool for the prevention of these cancers. At the same time a benign or malignant vaginal growth is removed, where possible the female dog should be spayed in order to reduce the risk of primary recurrence.
It is always advisable to be alert for signs of a health problem, and seek prompt veterinary treatment. In some cases this could allow for the identification of a vaginal tumor in the early stages. This may then mean the option for less invasive surgery (episiotomy) is available.
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