Upon examination by Dr. Kirsten Plomin of Hinsdale Animal Hospital, Tequila was noted to have a large vaginal hood and a recessed vulva. This combination was causing the area to remain moist, leading to repeated bacterial colonization of her urinary tract and significant discomfort for Tequila.
Knowing this, the owner tried wiping between the folds and cleaning Tequila after every urination, however, the UTIs were persistent due to the redundant tissue and recessed vulva. Surgery was discussed and in order to prevent future urinary tract infections, a vulvoplasty – also known as an episioplasty – was recommended. This procedure involves creating a shallow incision in a horseshoe shape around all the skin folds and removing the redundant tissue and underlying fat. This lifts the skin around vulva, pulling it into a more normal conformation. Restoring the normal conformation of the vulva helps improve ventilation in this area, allowing the skin to dry out and making it more difficult for bacteria to grow. Additionally, this surgery prevents skin layers from rubbing together and further contribution to vulvar inflammation.
Tequila did great during surgery and went home the same day with nonsteroidal anti-inflammatory medication to prevent pain and swelling at the surgical site. She wore an Elizabethan collar, or cone, to prevent her from licking at the site which could lead to infection. Her sutures were removed in 10 days and no complications were encountered.
To date, Tequila has been UTI-free! In general, the prognosis after a vulvoplasty is excellent and should be considered for dogs with recessed vulvas and recurrent urinary tract infections.
