Journal of Entomology and Zoology Studies 2020; 8(2): 1108-1112

E-ISSN: 2320-7078
P-ISSN: 2349-6800
www.entomoljournal.com
Hysteroscopic and ultrasonographic evaluation of
JEZS 2020; 8(2): 1108-1112
© 2020 JEZS
goat (Capra hircus) uterus
Received: 13-01-2020
Accepted: 15-02-2020
Pankaj Kumar, Sandeep Dholpuria and GN Purohit
Pankaj Kumar
MVSc Scholar, Department of
Veterinary Gynecology and Abstract
Obstetrics, College of Veterinary Abattoir derived goat (Capra hircus) genitalia were examined (n=197) by visual examination,
and Animal Science Rajasthan ultrasonography and hysteroscopy and 31 (15.74%) revealed pathologies involving the uterus. For the
University of Veterinary and pathologies detected endometritis showed the highest prevalence (45.16%) followed by hemorrhages on
Animal Sciences, Bikaner, the endometrium (19.35%), hydrometra (16.13%), mucometra (9.86%) and pyometra (9.68%). The
Rajasthan, India sensitivity, specificity, positive and negative predictive values for diagnosing these abnormalities was
highest for endoscopy followed by ultrasonography and visual observations or palpation. It was difficult
Sandeep Dholpuria to pass the endoscope used in the present study (5.5 mm) through the cervix in the goat uterus in 55.8%
Assistant Professor, Department genitalia without a cut on the cervix. It was concluded that hysteroscopy is a better technique for the
of Veterinary Gynecology and diagnosis of minor pathologies in the uterus such as endometritis and hemorrhages in goat but the
Obstetrics, College of Veterinary endoscope diameter should be 2 mm.
and Animal Science Rajasthan
University of Veterinary and
Animal Sciences, Bikaner,
Keywords: Goat, hysteroscopy, ultrasonography
Rajasthan, India
Introduction
GN Purohit Pathological studies on goat reproductive tract have revealed that the uterus is the organ that
Professor and Head, Department was the most affected [1, 2]. A major limitation to the evaluation of goat uterus is its
of Veterinary Gynecology and
Obstetrics, College of Veterinary
inaccessibility to palpation and visual inspection. With the availability of ultrasonography
and Animal Science Rajasthan some of the pathologies of the goat uterus such as hydrometra and mucometra can be
University of Veterinary and identified [3-5] but the most common uterine pathology (endometritis) is still difficult to be
Animal Sciences, Bikaner, evaluated by ultrasonography. In recent years endoscopy has gained popularity for direct
Rajasthan, India visualization of the internal morphology of uterus and other hollow organs adding information
on normal and/or abnormal changes in mares [6, 7], cattle [8] and buffaloes [9, 10]. Although
Roberts [11] was the first to examine the genitalia of ewes using endoscopy, the technique of
hysteroscopy has not gained popularity for clinical use in the small and large domestic
ruminants on account of the anatomic structure of the cervix [12]. Hysteroscopy has been
reported for the rabbit [13] and in the goat [14, 15] but the hysteroscopic appearance in uterine
pathologies was not recorded. The ultrasonographic evaluation of goat uterus has been
reported [3] and its use for diagnosis of pathologies such as mucometra and hydrometra has
been documented [4, 5]. Endometritis in the goat has been postulated to be a possible cause for
further development of mucometra/hydrometra in the goat [16] and these conditions have been
diagnosed using ultrasonography in the goat [3]. Ultrasonographic evaluation of uterine
pathologies such as endometritis continues to be a difficult approach and minor changes might
escape the clinician’s diagnosis. It would thus be appropriate to visualize the lumen of the
uterus directly. The present study evaluated the usefulness of hysteroscopic and
ultrasonographic evaluation of abattoir derived goat genitalia.

Materials and Methods

Goat genitalia were procured from a local abattoir immediately after slaughter and transported
Corresponding Author: to the laboratory in warm normal saline. The study was performed from October 2018 to
Pankaj Kumar November 2018. After visual inspection and palpation the genitalia
MVSc Scholar, Department of were immersed in a water bath and examined by real time ultrasonography as described
Veterinary Gynecology and
Obstetrics, College of Veterinary
previously [17, 18] using a color Doppler ultrasound system (EDAN, U2 prime, Paul Medical
and Animal Science Rajasthan Systems, India) with a dual frequency (8.0-13.4 MHz) linear array transducer and the images
University of Veterinary and were stored in the multimedia kit attached to the ultrasound equipment. The internal structures
Animal Sciences, Bikaner, of the uterus were examined by hysteroscopy using a rigid endoscope (Karl Storz, Germany)
Rajasthan, India as per previously described procedures [9].
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The Karl Storz endoscope with HOPKINS telescope (300) 5.5 suggests that a 2mm endoscope should be used in goats as
mm diameter with a C-mount camera connected to the also suggested previously (Colagross-Schouten et al., 2014)
[14]
endoscope with light cable was used and the pictures were . The mean cervical diameter in goats varies from 1.07 +
saved on the computer with AIDA compact. A small cut over 0.17 to 1.75 + 0.04 cm (Adwige and Fayemi, 2005; Gupta et
the cervix was applied if it was not possible to pass the al., 2011) [23, 24] (and the cervical canal reveals different
hysteroscope in the uterine lumen. Once the hysteroscope was anatomic structures with 4.3 cervical folds (Dayan et al.,
inside the uterus a small amount of air was insufflated inside 2010) [25]. Thus, the cervical anatomy is an impediment to the
the uterus to visualize the internal structures clearly. easy passage of the endoscope in the goat uterus. Similarly,
Endometritis was considered when the uterine endometrium clinical studies in cattle have pointed out that the cervical
revealed thickened wall on ultrasonographic examination [17] anatomy limits the easy passage of hysteroscope in the bovine
or disrupted uterine endometrium and/or color uterus (Metzner et al., 1992; Mordak et al., 2008) [26, 27].
changes with thickening on endoscopic examination [19]. The Hysteroscopy had a higher sensitivity and specificity for
sensitivity and specificity of diagnosis of uterine pathology diagnosing endometritis in the present study as also
were calculated using hysteroscopy as the reference method previously mentioned for cattle (Madoz et al., 2010) [19].
as described previously [19]. The results of visual/palpation or Hysteroscopic features of endometritis during the present
ultrasonography were interpolated with the Hysteroscopic study included corrugated appearance and grayish
findings to calculate the sensitivity (Se), specificity (Sp), discoloration which are similar to previous reports in cattle
positive predictive value and negative predictive value as (Madoz et al., 2010; Mordak et al., 2007) [19, 22] and buffalo
described previously [20]. (Purohit et al., 2013) [9].
Hemorrhages observed by hysteroscopy in the present study
Results have also been observed in previous studies in cattle (Madoz
Out of 197 goat genitalia examined by visual, et al., 2010) [19] and buffalo (Chaudhary et al., 20140 [10] yet
ultrasonographic and hysteroscopic examination (Fig.1), 31 they could not be observed by ultrasonography in the present
(15.74%) were detected with different uterine abnormalities. or previous studies (Purohit et al., 2013) [9]. Because of
For the genitals examined it was not possible to pass the accumulation of fluid in pyometra and mucometra they could
hysteroscope in the uterus without a cut on the cervix (due to be diagnosed by both ultrasonography and hysteroscopy and
extremely smaller size) in 55.8% (110/197) of the goat uteri. the enlargements were also palpable. It was concluded that
Amongst the recorded pathologies the incidence of hysteroscopy is a better technique for the diagnosis of minor
endometritis was highest (45.16%) followed by hemorrhages pathologies in the uterus such as endometritis and
on endometrium (19.35%), hydrometra (16.13%), mucometra hemorrhages which can interfere with fertility but the
(9.86%) and pyometra (9.68%). Endometritis and endoscope diameter should be 2mm.
hemorrhages over endometrium could not be detected by
visual/palpable examination whereas a thickened uterine wall
with moderate to large amount of fluid within the uterine
lumen along with snowy patches could be visualized by
ultrasonography. Hysteroscopic visualization detected a
higher proportion of uteri with endometritis and revealed,
grayish discoloration (Fig. 2), fungal plaques or erosion of
endometrium (Fig. 3) or corrugated appearance (Fig. 4).
Hysteroscopy could also detect mucometra (Fig. 5), pyometra
(Fig. 6), hydrometra (Fig.7) and hemorrhages (Fig. 8).
Hydrometra could also be detected by ultrasonography by the
presence of anechoic fluid (Fig. 9). The Se, Sp, PPV and NPV
for prediction of hydrometra, pyometra and mucometra was
100% for both hysteroscopy and ultrasonography while for
endometritis the Se and NPV were 57.14% and 96.83% for
ultrasonography and the NPV, Se and PPV were 96.95%, 0% Fig 1: Endoscopic picture of a normal goat uterus
and 0% respectively for endometrial hemorrhage detection by
ultrasonography. Out of the 6 uteri with hemorrhages the CL
was present only in 1 goat genital examined.

Discussion
Hysteroscopic visualization of the goat uterus using a rigid
endoscope during the present study is partly similar to reports
in cattle (Madoz et al., 2010) [19] and buffalo (Purohit et al.,
2013; Chaudhary et al., 2014) [9, 10] that utilized a rigid
endoscope for visualization of uterine pathology, however a
few reports mentioned the use of flexible endoscopesfor
hysteroscopy (Karen et al., 2001; Devine and Lindsey, 1984)
[21, 22]
. The two studies in goat used a specially designed
endoscope (Colagross-Schouten et al., 2014; Xu et al., 2014)
[14, 15]
of a smaller diameter. Using the 5.5 mm endoscope in Fig 2: Endoscopic picture of a goat uterus with endometritis showing
the present study it was not possible to pass the scope in grayish discoloration
55.8% of the goat uterus without a cut over the cervix. This
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Fig 3: Endoscopic picture of a goat uterus with endometritis showing Fig 6: Endoscopic picture of a goat uterus with pyometra. The
surface erosion endometrial congestion and the accumulated pus is visible.

Fig 4: Endoscopic picture of a goat uterus with endometritis showing

a corrugated appearance Fig 7: Endoscopic picture of a goat uterus with water accumulation
(hydrometra)

Fig 5: Endoscopic picture of a goat uterus with mucometra Fig 8: Endoscopic picture of a goat uterus with hemorrhages

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Fig 9: Ultrasound image of a goat uterus with water accumulation (hydrometra)

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