Surgical Removal of Urethral and Bladder Stones in Female Asian Elephant (Elephas maximus) by Episiotomy and Urethrotomy

A 45-year-old female Asian elephant (Elephas maximus) was presented with urinary incontinence and solid masses at the perineal area. Vaginoscopy revealed stricture of the vaginal vestibule. Trans skin and rectal ultrasonography demonstrated presence of hyperechogenic uroliths. Episiotomy and urethrotomy were performed after standing sedation with xylazine and perineal infiltration with lidocaine. Total of 8 kg urethral calculi were retrieved manually. Calcium carbonate was identified as the main component of the stones. Due to acute urinary obstruction after the operation, an episiotomy was left open, allowing urine to pass through the incision. Following urine scalding, necrotic tissues were detected along the tracts below the incision wound through umbilicus. Daily wound cleaning and antibiotics treatment for one month were performed. The episiotomy wound was left to heal by secondary intention and led to a 2 cm stricture. The healing process completed in 5 months post-operatively. The elephant can urinate via normal tract in 8 months after surgery.