Cervical wedge resection for treatment of pyometra secondary to transluminal cervical adhesions in six mares.

This study explores the use of cervical wedge resection, a surgical procedure, to treat pyometra (uterine infection) in mares, caused by transluminal cervical adhesions. The findings indicate all six mares treated in this way saw a resolution of their pyometra, without the need for more invasive surgeries.

Objective and Methodology

• The study focused on evaluating the methodology and effectiveness of cervical wedge resection for treating pyometra caused by transluminal cervical adhesions in mares. 6 mares who exhibited signs of uterine infection were chosen for the study.
• The mares were admitted to the hospital for different reasons, including infertility (seen in 5 mares) and drastic colic (in one mare).
• In each mare, a rectal examination of the reproductive tract and transrectal ultrasonography was conducted. These procedures identified uterine distention and the presence of fluid accumulation within the uterus, suggestive of an infection.
• A vaginal speculum examination and cervical palpation further revealed the presence of transluminal cervical adhesions. Three of the mares presented severe cervical distortions due to diverticula and fibrosis.
• The diagnosis of pyometra secondary to transluminal cervical adhesions was made in all 6 mares.

Treatment Procedure and Results

• The first step in the treatment involved manually breaking down the cervical adhesions to create a patent cervical lumen that could accommodate a uterine lavage catheter.
• Once accomplished, a sample of the uterine content was taken for bacterial culture testing and antimicrobial susceptibility evaluation. Afterward, the uterus was cleaned using a 0.05% povidone-iodine solution to rid it of the mucopurulent exudate.
• The mares then underwent cervical surgery in a standing position post-sedation and caudal epidural anesthesia. During the surgery, a full-thickness wedge-shaped defect was created in the dorsolateral aspect of the cervix, forming a permanent opening to the uterus.
• Postoperative care comprised of applying topical medication to the cervix to prevent the reformation of adhesions.
• The result was successful in all mares, with the cervix staying patent and pyometra getting resolved post-surgery.

Conclusion

• In conclusion, the study demonstrated that cervical wedge resection can provide an effective treatment for pyometra in mares with transluminal cervical adhesions, eliminating the need for more invasive methods like ovariohysterectomy.