Hello again. In the next installment of my brand new blog, I was going to introduce you to my menagerie of pets. However, a pressing veterinary topic presented itself over a chicken and black bean burrito, and I feel compelled to tell you about it. 
 

I was eating at the burrito place, reading a Dallas alternative newspaper that is available for free at said restaurant. I always read this at the burrito place because it makes me feel cool and trendy while sitting there all alone (among all the legitimately cool, trendy people eating with their friends).

Anyhow, I came across an ad recommending that men get their lady friends the gift of plastic surgery. As I mentioned, I live in Dallas, Texas. Reconstructive surgery seems to be as integral to the women around here as food and air. Sometimes there are so many painfully thin, unnaturally tan, blonde women with large boobs around that it’s difficult to tell them apart. 

This ad was different, though. It was for, among other things, "labioplasty" — reconstruction of, for lack of a better term, the "lady bits." Are you kidding me? Who does this? Unless you work in an industry where that area is being photographed, or viewed on a regular basis, I can’t fathom a need for this. Frankly, that area is just not an attractive body part, regardless of its age or status. 

I can’t imagine any husband saying "Honey, I notice things are a little droopy down there. I think it would really spice things up if you went and got yourself a little 'lift.'" 

This brings me to the veterinary version of this: vulvoplasty. 

In my world there is an actual medical indication to "lift and separate" those parts, and it is definitely not cosmetic. 

First, a little background info: Bacterial urinary tract infections are a relatively common occurrence in female pets and humans alike. The urethra ("you pee-thra the urethra"; that’s how we learned it in vet school) is the tube that goes from the bladder to the cold, cruel world outside. Males have really long, skinny ones that make it hard for bacteria to crawl up into the bladder.

Females, on the other hand, are blessed with short, fat ones that often provide a nice portal for bacteria to travel through. This is also why girls get more bladder infections than boys.

Occasional urinary tract infections (UTIs) in females aren’t really a big deal. A course of antibiotics and a few days later, things are right as rain. However, recurrent UTIs are a problem. Sometimes there is a problem in the bladder, like stones, a tumor, or other anatomic abnormalities.

Other times there are problems with the external anatomy:

  • Hormone responsive urinary incontinence, where a leaky sphincter lets urine out and bacteria in. 
  • Overweight cats often can’t get back there to clean things up, resulting in mats of fur and urine that contaminate the area. (AKA "fat cat cheese butt")
  • Anatomic abnormalities of the vulva itself in dogs. 

This is where the whole plastic surgery thing comes in. The normal vulva of a dog looks like this little fleshy pink triangle that kind of hangs out by itself. It shouldn’t be surrounded by any extra skin; this provides a nice portal for urine to get out. In some dogs, the vulva is "recessed"; it’s buried under a bunch of extra skin. This extra skin tends to get in the path of urine output and stays slightly moist with urine. Bacteria comes along, because it loves moist, dark places, and causes dermatitis, irritation, discomfort and recurrent UTIs.  Some dogs are born with recessed vulvas. Other dogs, of the more "plump" variety, develop them as a result of being too heavy. Dogs with a lot of folds in general, like Bulldogs and Shar-Peis, can have extra skin "down there" too.  

First thing we do in these situations is to get the dogs to lose weight if they are too heavy. This fixes the problem maybe half the time.   

If weight loss doesn’t work, then we talk surgery. Vulvoplasty or episioplasty is reconstructive surgery to help remove some of those excessive folds. A little "lift," if you will. This is not just done to make things more aesthetically pleasing down there, though. Nope. This rather delicate plastic surgery is actually medically warranted.

The dog has her surgery, she’s uncomfortable for about a week, and then, with a little luck, no more infections. And who knows, maybe the boy dogs will find her new girl parts "fetching" … ha, ha … bad pun intended ;)

So there you have it. I bet you never thought a burrito could lead to a tumultuous (ok, that may be overstating it a little) tale of urine and plastic surgery, did you? Well, that’s just how my mind works, go figure.

Dr. Vivian Cardoso-Carroll

Pic of the day: The Burrito Shop by Claire Grossheim