Prosthetic perineal herniorrhaphy in a buffalo

An 8 year old Murrah buffalo pregnant of about three months was treated for a football size soft swelling on the left perineal region. On clinical examination the swelling was soft, fluctuating, reducible and painless. Animal was showing dribbling of urine for last 5–7 days. The case was tentatively diagnosed as unilateral left perineal hernia. History revealed that during last calving animal was treated for dystocia, one month after that an egg shaped swelling developed left to the anus, which gradually attained a football size in 16–18 months. Anorexia and decrease in milk production were seen. Pressing of bladder and catheterization confirmed the herniation of bladder. The buffalo was sedated with Triflupromazine hydrochloride I.M. and then posterior epidural anaesthesia was given using 12 mL of 2% xylocaine hydrochloride. Perrectally the faeces were removed and purse string suture was applied around the anus. Animal was operated in standing position. An elliptical incision was given on swelling and after reflection of skin, the tissue was separated bluntly. Urinary bladder and loops of intestine were found as contents of the hernial sac, which were freed of adhesions and were replaced. The hernial ring measuring about 4–5 inch in diameter was exteriorized. The musculature was thin and apposition was difficult therefore a double fold pre-sterilized, nylon mosquito net was placed over the ring and anchored with Mersilk suture No. 1 in entire periphery by interrupted mattress suture. The available levator ani muscle and coccygeous muscles were sutured as much as possible with external anal sphinctor muscle with Vicryl No. 1 using simple interrupted sutures. There after rest of the tissues were approximated with chromic catgut No. 2 in simple continuous pattern. After this povidone iodine and metronidazole lotion were applied on the suture line. Next the skin edges were sutured by cross mattress pattern using satin tape half inch. On fourth day two skin sutures showed disruption. The wound was dressed with povidone iodine and metronidazole lotion. Animal was given Inj Intamox 3g, Inj Melonex, 15 mL, and Ringer's Lactate 1L daily for three days. Post-operatively animal was kept in slope with raised hindquarter and diet was restricted. On 12^th day rest of the sutures were removed and animal made uneventful recovery. Presently animal is healthy elivered a male calf after full gestation and is now in a healthy lactating status.