Alternative Approach to the Caudal Abdomen in Male Dogs

The standard surgical approach to the caudal abdomen in male dogs involves extensive subcutaneous dissection, severance of preputial muscles, and ligation of the branches of the caudal superficial epigastric vessel. The objective of this study was to describe an alternative approach. 

The medical records of 12 dogs that had undergone a ventral midline preputial incision of the ventral midline were retrospectively reviewed. The initial incision was centered over the ventral midline of the prepuce beginning cranially, approximately 1 cm caudal to the fornix of the prepuce. This incision exposed the ventral aspect of the internal preputial lamina, which was then retracted. Sharp dissection of the subcutaneous tissue was continued down to the linea alba. 

Surgical procedures requiring this approach included cystotomy, prostatic cyst removal and biopsy, cystotomy with prostatic biopsy and correction of a retained abdominal testicle, cystotomy with urethrostomy, and prostatic biopsy and castration. All dogs recovered uneventfully, and there were no major complications. Two dogs that underwent cystotomy and scrotal urethrostomy had mild-to-moderate postoperative edema and swelling but did not require additional intervention. 

The authors concluded that the ventral midline preputial approach to the caudal abdomen of the male dog is appropriate when exposure of the urinary bladder or prostate is all that is required.

Global Commentary

This study describes a simple, safe, and useful technique. It is true that an experienced surgeon can perform the approach to the caudal abdomen at the lateral aspect of the penis with dissection of the soft tissues to the linea alba using a small incision and without cutting the protractor preputii muscles; however, that is less direct than this technique. This new approach may be a safe and direct method for less experienced surgeons; however, if further exposure is required, this approach has limitations and becomes more complicated. The ventral midline preputial approach is one that clinicians might keep in mind for select cases that do not require more exposure.

—Esteban Pujol, DVM, DECVS