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Friday, September 2, 2016

Fixing A Hooded Vulva (Vulvoplasty/Episoplasty)

Here's one I bet most people never thought of.  "Cosmetic" surgery on a dog's genitals.  But it's really not for the sake of appearance.

Some female dogs have what we'll call a "hooded" or recessed vulva.  A normal dog's genitals should be easily visible and not hidden.  But sometimes there are folds of skin that cover the vulva.  This causes several problems.  First, the urine can stay in contact with the skin and get into the folds on either side of the vaginal opening, causing irritation and leading to infections.  Second, the close contact of the skin with the outer vulvar lips can make it easier for bacteria to get into the vagina, ascending to cause bladder infections.

My latest case of this was plagued by chronic infections and discharge to the skin around her vulva.  Antibiotics and medicated wipes would help for a little while but the problem would always come back.  The deep folds trapped urine and other moisture, leading to the ongoing disorder.  Besides the irritation to the pet there was a persistent foul odor that the owners didn't like.  And I can't say that I blame them!  When repeated medical therapy didn't resolve the issue we decided to do surgery.

Here are some pictures with her anesthetized and on the surgery table.  You can see in the first one that her vulva is not visible at all, deeply hidden in the recesses of the skin fold.  This is not normal! 

In this photo I'm pulling the folds apart so that you can see the vulvar lips.  This is what should be readily visible in a female dog.  You can see the big difference between the pictures and the kind of problem she had.

The surgery is often called a vulvoplasty, but is more properly called an episoplasty.  It involves cutting away the excessive folds of skin and returning the area to a more normal structure.  When the skin folds are removed we suture the incision together.  You can see the post-operative appearance in the picture below, which returns her to a very normal conformation.

I took the sutures out 10 days later and the incisions had healed very well.  There was no infection or odor, and the skin in the area was returning to a normal appearance.  This dog will no longer be plagued by chronic infections around her genitals.

Not every vet will perform this procedure as it's a more advanced soft tissue surgery.  I enjoy these kinds of surgery so I learned how to do it and have done several of them.  But if your vet is not comfortable doing it they may refer you to a specialist.  If you think that a hooded vulva may be the cause of odor or infection around your dog's genitals, have your vet evaluate her.