VSR 421: Regional Veterinary Surgery (2+1)

TREATMENT

• Treatment involves the use of appropriate antibiotics, castration to reduce the size and activity of the prostate, drainage of abscesses, omentalization, marsupialization and partial or complete prostatectomy.
• Prostatic and paraprostatic cysts may result from the increased production of prostatic fluid or a structural or functional obstruction to the outflow mechanism. The accumulated secretions may get secondarily infected and form abscesses. Clinical signs may be produced due to the physical obstruction caused by the enlarged cysts as in prostatic abscesses except for the signs related with infection and sepsis. Diagnosis is also made by the techniques described earlier. Culture of the prostatic secretions reveals no bacteria except in cases with secondary bacterial infection.
• Surgical treatment is aimed at drainage, removal or debulking of the affected prostatic tissue and omentalization of the remnants. Castration is also recommended.
• Prostatic tumours typically affect old dogs and can be prevented by castration. Though adenocarcinoma and transitional cell carcinoma are most common in dogs other types have also been reported. Clinical signs are produced by the physical obstruction to the urinary and fecal outflow. Also, other signs of neoplasia like cachexia, anorexia and pain will also be pronounced.
• Metastasis to adjacent and distant organs also produces related symptoms. Rectal or abdominal palpation reveals a painful, firm, irregular and nodular prostate which may or may not be adherent to the surrounding structures. Lymphadenopathy may be palpable or may be ultrasonographically visualized. Biopsy may be performed for differentiation of the condition from other conditions that cause an enlargement in the size of the prostate.
• Treatment by prostatectomy may be performed before the tumour has started metastasizing. Advanced cases have poor prognosis.
• Trauma of prostate may occur because of trauma to the pelvic region resulting in pelvic fractures or penetrating caudal abdominal injuries. Mild cases may be treated by establishing the patency of the urethra by catheterization and allowing the damaged gland to heal by second intention.
• In cases where catheterization cannot establish patency of the urethra an exploratory laparotomy may be performed and the damaged prostate may be repaired by suturing the capsule. Partial or excisional prostatectomy may be performed in severe cases of prostatic trauma.