Bovis ISSN 2398-2993

Bühner suture: method

Synonym(s): uterine prolapse, vaginal suture

Contributor(s): Ash Phipps , John Tulloch

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Introduction

  • The Bühner procedure involves placing a buried suture to constrict the vestibule region.
  • It is believed to aid in the prevention of vaginal or uterine eversion.

Uses

  • A Bühner suture is used to treat:
    • Eversion of the vagina/cervix (Vaginal prolapse Vaginal prolapse).
    • Eversion of the uterus (Uterine prolapse Uterine prolapse).
      • Opinions differ as to whether the Bühner suture should be used for uterine prolapse cases - see disadvantages.

Advantages

  • Relatively easy procedure to carry out.
  • Minimally invasive procedure.

Disadvantages

  • The cow will require assistance at parturition if the Bühner’s suture is still in place. 
  • There is some controversy as to whether Bühner sutures should be used on cattle with uterine prolapse. The author and reviewer themselves disagree on this point!
    • The author's opinion is that it is a safe technique to use on selected prolapsed uterus cases. The author feels that most uncomplicated cases do not re-prolapse after replacement. The author feels that the Bühner is a useful technique for cows that remain recumbent or continue to strain after uterine replacement.
    • The reviewer feels that this is not an appropriate technique for uterine prolapses.  The reviewer has had to deal with a number of cases whereby a cow has re-prolapsed and has badly damaged the uterus and vagina when prolapsing with a Bühner suture in place.
Published evidence as to the appropriate use of this technique appears to be lacking and so until we have definitive evidence either way, we can only provide the reader with the technique and our thoughts and allow you to make up your own mind!

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good - Low incidence of complications.

Further Reading

Publications

Refereed Papers

  • Prado T M, Schumacher J & Dawson L J (2016) Surgical Procedures of the Genital Organs of Cows. Veterinary Clinics of North America: Food Animal Practice32 (3), pp 727-752.

Other sources of information

  • Divers T J & Peek S (2007) Rebhun's diseases of dairy cattle. Elsevier Health Sciences. St Louis, Missouri, USA.
  • Fubini S L & Ducharme N (2004) Farm animal surgery. Elsevier Health Sciences, St Louis, Missouri, USA.


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