Bovis ISSN 2398-2993

Buhner method

Synonym(s): uterine prolapse, vaginal suture,

Contributor(s): Ash Phipps , John Tulloch

University of Liverpool logo

Introduction

  • The Bühners method is a procedure where a buried suture is placed to constrict the vestibule region to aid in the prevention of vaginal or uterine eversion.

Uses

  • A Bühner stitch is used for treatment of cows with:
    • Eversion of the vagina/cervix (Vaginal prolapse Vaginal prolapse).
    • Eversion of the uterus (Uterine prolapse Uterine prolapse).
      • There are varying opinions as to whether a Bühner should be used for uterine prolapses – see disadvantages...

Advantages

  • Relatively easy procedure to carry out.
  • Minimally invasive procedure.
  • When used under the correct circumstances; it is an effective procedure for the treatment eversion of the uterus and vagina.

Disadvantages

  • For vaginal prolapses; the cow requires assistance at parturition if the Bühner’s stitch is still in place, or the vulva may be traumatized and/or the cow may be unable to deliver the fetus.
  • 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 select prolapsed uterus cases, as 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

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Preparation

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Procedure

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Aftercare

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

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.


ADDED