Borescopic examination added the view to confirm the case as persistent hymen and to visualize its complete structure. During borescopic examination, a thick transverse membranous muscular band was diagnosed as persistent hymen in front of vestibulo-vaginal junction (Fig 4). The animal was given epidural anesthesia with 2% Lignocaine HCl @ 1 ml/100 kg b. wt. The hymen membrane was punctured by borescopic aided hymenotomy using obstetrical hook for small ruminants. Subsequently, the punctured hymen was completely torn by passing the hand with gentle pressure. Further, borescopic examination through the passage revealed accumulation of mucus like fluid in the vagina (Fig 5). About 2 litres of thick, gummy, tenacious, reddish brown colored mucus was evacuated from the vagina (Fig 6). Immediate borescopic examination revealed patency of the vagina. Later, intra-vaginal douche was given with 5-6 litres of 2% potassium permanganate solution. After flushing, vagina was examined using borescope through vaginal speculum and revealed normal patent vagina (Fig 7). Animal was injected with Inj. Streptopenicillin 5 grams i/m, Inj. Chlorpheniramine maleate 100 mg i/m and intra-uterine administration of suspension Ciprofloxacin and tinidazole 30 ml.
The treatment was repeated for 2 more days and the vaginal patency was checked using borescope. Animal showed an uneventful recovery and was observed in estrus after 22 days of hymenotomy. Animal was inseminated successfully and diagnosed pregnant after 45 days. By telephonic communication, the animal was followed continuously and the owner reported that the animal calved a male calf normally after 282 days of artificial insemination.
Persistent hymen was relatively rare in cattle, occasional in buffaloes
(Kumar et al., 2016) and also reported in human beings
(Yu and Lin, 1993). Complete obstruction of hymen in the present case caused accumulation of secretions in the vagina. Accumulation occurred as the normal outflow of the uterine secretions was prevented by the complete persistency of the hymen leading to accumulation of fluid that increased with the age and the cyclic ovarian activity of the animal
(Troiano and McCarthy, 2004). In the presented case, about 2 litres of thick, gummy, tenacious, reddish brown colored mucus was evacuated from the vagina. Similarly, red copious discharge was evacuated by
Kumar et al., (2020) in a HF heifer.
Madhusudhan et al., (2016) found that the duration and the volume of fluid accumulated might had affected the endometrium via pressure atrophy leading to embryonic loss if fertilization had occurred or some permanent blockage might have occurred that prevented fertilization. But in the present case, the animal conceived in the subsequent estrum itself, which might be due to the sterile environment maintained in the uninfected uterus.
In this case, hymenotomy was performed by puncturing the hymen using sharp long obstetrical hook for small ruminants. Incising the hymen at the point of greatest bulge followed by enlarging the incision at the right angles longitudinally in all four directions or by circular incision on outer hymenal border was recommended by
Roberts (1971).
Dascanio (2014) suggested that if the hymen does not rupture with digital pressure, a surgical procedure may be needed to open the thickened membrane. The patency of the hymen was achieved by making circular incision using BP blade No. 22
(Chaudhary et al., 2007) and trocar guarded by finger and the opening was further dilated by digital pressure
(Kumar et al., 2016). The recurrence of the condition was noticed by
Singh and Singh (1999) which did not occur in the present case. The recurrence could be prevented by douching of vagina with potassium permanganate and boroglycerine lotion
(Singh and Singh, 1999). In the present case, intravaginal douching was done with 2% potassium permanganate solution to prevent adhesions at incision site and the patency was visualized with borescope.
In the present case, ultrasonographic view revealed ovaries were normal with follicles.
Singh and Singh (1999) have reported a successful treatment of a heifer that calved subsequently. Similarly, in this case the prognosis in terms of fertility was good and the animal had calved successfully. In the present case, borescope was used as a new diagnostic aid in the field of animal reproduction as an alternative for endoscope and vaginoscope which are costly and not available under field condition. Whereas, the borescope is portable, cheap and highly useful to diagnose defects in the vagina and external os of the cervix. The device is also helpful in documentation of the conditions by recording the videos and pictures through a mobile phone or a laptop.
