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Speaking Out Response

Dr. Veenis’ point is well taken; ovariectomy is an alternative procedure to ovariohysterectomy in healthy, nongravid bitches. We chose the ovariohysterectomy procedure for our minimally invasive project because it is the more common procedure performed in the United States.¹

Laparoscopic ovariectomy would be an interesting procedure to describe; however, it is possible that the complications of hemorrhage, cystic endometrial hyperplasia, and urinary incontinence would be of the same frequency and type in both minimally invasive techniques as they are in the open procedures.² One disadvantage that ovariectomy might hold is that exposure to progestational compounds, whether endogenous (ovarian remnant, progesterone-producing tumor) or exogenous (for dermatological disease),¹ is likely to result in a more profound mucometra, hydrometra, or pyometra simply because of the amount of tissue involvement. The risk of this development appears to be low, as one review of 72 animals ovariectomized and followed for 4 to 9 years had no incidence of pyometra.³ Another study, to which Dr. Veenis referred, found no incidence of cystic endometrial hyperplasia in 69 bitches that had ovariectomy or 66 bitches that had ovariohysterectomy performed.² While the incidence of hydrometra, mucometra, and pyometra in bitches that have had ovariectomy or ovariohysterectomy performed is low enough that it is not seen in the studies previously referenced, there is still evidence that these complications can occur in the presence of progestational compounds.^4,5 Because the complication is potentially fatal, some surgeons may still choose to perform ovariohysterectomy.

As Dr. Veenis notes, it has been shown in open procedures that adhesions can form with ovarian, uterine horn, and uterine stumps that sometimes result in colonic or ureteral obstruction.^6–9 Due to the formation of colonic obstructing adhesions with incompletely resected uterine horns, two authors recommend resecting the uterus as close to the cervix as possible to decrease the incidence of this complication.^8,10 Three reports also describe colonic obstructing adhesion formation with the cervical stump.^6,7,11 In our opinion, these reports demonstrate that the complications attributed to the cervix and transected broad ligament can also occur with any tissue ligated and transected in the abdomen. Therefore, in our opinion, neither surgical procedure has yet been shown to be superior, and the choice should remain the surgeon’s preference.

Finally, minimally invasive is not the equivalent of minimal surgery. Therefore, both techniques can be adapted for minimally invasive techniques. A retrospective study with a large population may eventually demonstrate the superiority of one technique performed in a minimally invasive manner, or it may remain, as it is currently in the open technique, surgeon’s preference.

Brenda Austin, DVM and Otto Lanz, DVM, Diplomate ACVS

From the Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Phase II, Duck Pond Drive, Blacksburg, Virginia 24061.

References

1. Stone EA. Ovary and uterus. In: Slatter DH, ed. Small animal surgery. 3rd ed. Philadelphia: WB Saunders, 2002:1487–1502.
2. Okkens AC, Kooistra HS, Nickel RF. Comparison of long-term effects of ovariectomy versus ovariohysterectomy in bitches. J Reprod Fertil Suppl 1997;51:227–231.[Medline]
3. Janssens LAA, Janssens GHRR. Bilateral flank ovariectomy in the dog - surgical technique and sequelae in 72 animals. J Sm Anim Pract 1991;32(9):249–252.
4. Pearson H. Ovariohysterectomy in the bitch. Vet Rec 1970;87:646–647.[Medline]
5. Pearson H. The complications of ovariohysterectomy in the bitch. J Sm Anim Pract 1973;14:257–266.
6. van der Gaag I. [Enterological complications following ovariohysterectomy in dogs.] Tijdschrift voor Diergeneeskunde 1981;106(23):1199–1207.[Medline]
7. Coolman B, Manfra Marretta S, Dudley MB, Averill SM. Partial colonic obstruction following ovariohysterectomy: a report of three cases. J Am Anim Hosp Assoc 1999;35:169–172.[Abstract]
8. Muir P, Goldsmid S, Bellenger C. Megacolon in a cat following ovariohysterectomy. Vet Rec 1991;129(23):512–513.[Medline]
9. Okkens AC, Van der Gaag I, Biewenga WJ, Rothuizen J, Voorhout G. [Urological complications following ovariohysterectomy in dogs.] Tijdschrift voor Diergeneeskunde 1981;106(23):1189–1198.[Medline]
10. Smith M, Davies N. Obstipation following ovariohysterectomy in a cat. Vet Rec 1996;138:163.[Medline]
11. Furneaux RW, Boysen BG, Mero KN. Complications of ovariohysterectomies. Can Vet J 1973;14(4):98–99.[Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Austin, B. Articles by Lanz, O. Search for Related Content PubMed PubMed Citation Articles by Austin, B. Articles by Lanz, O.