Abstract

Due to development and implementation of a chimpanzee reproduction program at the National Zoo in Havana, Cuba, uterine morphology was evaluated in an adult female chimpanzee (Pan troglodytes troglodytes). Uterine evaluations were performed using the techniques of hysterosalpingography and laparoscopy. The hysterosalpingography revealed a normal uterus with a longitudinal diameter of 3 cm, cervix 2 cm in diameter, a channel cervix of 1.5 cm diameter, and the fallopian tubes were permeable. The laparoscopic examination revealed a subserosal uterine leiomyoma with external alterations in form and dimension. The lesions observed neither deteriorated the uterine endometrium, obstructed the fallopian tubes, or affected the internal capacity of the uterus. These results allowed the authors to consider this female chimpanzee potentially fertile.

Introduction

From the early 20th century there has been improvement in the use of endoscopic techniques in veterinary medicine.⁷ The first laparoscopic procedure in veterinary medicine, performed in 1985, involved uterine horn ties in a dog.⁹

A laparoscopy is an endoscopic procedure for the visual examination of the peritoneal cavity and its contents. It has been of great value in the diagnosis of the gynecological affections, the monitoring of reproductive cycles in domestic cats and wild animals⁸ in endosalpinx studies, the mobility and permeability of ducts, the fimbrio-ovarian relationship, and the characteristics of the peritoneum³. Other diverse uses such as, monitoring ovarian cycles, detection of anomalies of the abdominal organs, extractions of leiomyomas, and ovarian biopsies have been described.^1,7,9

A hysterosalpingography is the radiologic visualization of the uterine cavity through the introduction of a contrast agent into the cervix. The principal indication for this type of diagnostic examination is the study of sterility and infertility. The hysterosalpingography tests tubule permeability and is also indicated for the determination of the size and form of the uterus. This technique may also be applied to the detection of fallopian obstruction, channel narrowing, or dilatation. Although a hysterosalpingography can suggest the presence of adhesions, the specificity of this test is only 83%.³

A hysterosalpingography can be helpful in the diagnosis of uterus septate or bicorne, however, it is necessary to carry out a laparoscopy to establish the definitive diagnosis. A hysterosalpingography can be used to evaluate the size and thickness of the fallopian conduct, as well as the characteristic of the endosalpinx.^5,6 Hysterosalpingography and laparoscopy are important diagnostic tools in infertility studies to evaluate the general aspect of the internal genital.⁴

The present work describes the procedures used to carry out the gynecological evaluation of the genital apparatus in one captive female chimpanzee that had a previous history of infertility and stereotypic behavior, such as aggressiveness, indifference to the male, homosexuality, and hypermenorrhea.

Methods

A 33-year-old female chimpanzee housed at the National Zoological Park of Cuba was studied. The animal was anesthetized using xylazine (6 mg/kg IM) followed by ketamine (5 mg/kg IM). In addition to the gynecological examination, a complete physical examination and blood sampling for diagnostics and baseline serum sample banking was performed.

Following aseptic preparation of the vulvo-perineal region, the hypersalpingography was performed. With the cervix fixed and visualized, a metallic catheter was introduced through the cervix and 10 ml of a contrast agent (meglumine diatrizoate) was introduced prior to obtaining the radiographic film.

For the laparoscopic procedure, the point of insertion was half-line at navel level. A telescope degree O, rigid rectilinear vision scope was inserted, 4 mm in diameter and 25 cm long.

Results

The hysterosalpingography revealed a normal uterus with a 3 cm longitudinal diameter, a cervical diameter of 2 cm, a channel cervical diameter of 1.5 cm, and the fallopian tubes were permeable. The uterus appeared normal uterus (cavity free) without internal form alterations and fallopian conduct was permeable.

Laparoscopic examination of the uterus revealed the presence of leiomyomas and external alterations in uterine form and dimension. The leiomyomas appeared as a prominence in the peritoneal cavity in the form of a polypoid. Similar pathologies have been reported in humans.² Inflammatory lesions were also observed, characterized by multiple adherences from the uterus to the abdominal wall, which appeared to impede the appropriate mobility of the uterus. The existence of this pathology, in association with infectious agents, causes infertility.⁵ A microbial analysis performed prior the laparoscopy was negative. The inflammatory lesions observed may indicate previous infection.

Conclusions

A leiomyoma is a benign tumor composed of smooth muscle and conjunctive tissue. Classified by location, they may arise from one of the three uterine layers, endometrium, myometrium, and serosa.⁸ The initiating cause of leiomyomas is not known. In a few cases, leiomyomas can cause infertility, abortions, deterioration of the uterine endometrium, obstruction of the fallopian tube, or alter the position of the cervix, preventing correct sperm deposition.⁸ Leiomyomas may interfere with the capacity of uterine distension.¹⁰

The majority of leiomyomas cause few to no symptoms, but if observed, the most common symptoms are prolonged and intense hemorrhage during menstruation. The hypermenorrhea observed in the animal from this report may be a result of the leiomyomas detected during laparoscopic examination.

Although some alterations in the reproductive tract were detected in the female chimpanzee from this report, the internal capacity of the uterus was found to be unaffected. The external lesions observed in the uterus are compatible with previous uterine infections that were not present at the time of gynecological evaluation. Based upon the hypersalpingography and laparoscopic examination techniques utilized in the report, the authors consider this female chimpanzee to be potentially fertile.

Literature Cited

1.  Berik, J.S. 1996. Infertility. In: Rinehart, R.D. (ed.). Novak’s Gynaecology. W.S. Wilkins, Philadelphia, Pennsylvania. 923–925.

2.  Botella J., and J. Clavero. 1983. Enfermedades del aparato genital femenino. In: Botello, J. (ed.). Tratado de ginecología y obstetricia Tomo III. Editorial Revolucionaria. Habana, Cuba. 135–140.

3.  Collins, J.S. 1988. Diagnostic assessment of infertile female partner. Curr Probl Obstet Gynecol Fertil. 11:6–12.

4.  Diamond, M. 1992. Clinical obstetrics and gynecology. Pelviscopy. 34:2–6.

5.  Duke, G.A., and P.M. Bianchi. 1994. Surgery endoscopies gynaecological. Bull Esc Med. 23:123–126.

6.  Johns, A. 1993. Infertility and reproductive medicine. Clin N Am Endoscocopy. 4:2–4.

7.  Patterson, J.M. 1988. Laparoscopy. In: Kirk, R.W. (ed.). Current Veterinary Therapy. Terapeutica Veterinaria, Mexico City, Mexico. 36–50.

8.  Scott, J.R., P.J. DiSaia, and H. Spellacy. 1990. Gynaecology treaty and obstetrics, 6th ed. In: Scott, J.R. (ed.). Gynaecology Treaty and Obstetrics of Danforth. Interamericana. McGraw, Philadelphia, Pennsylvania. 633–640.

9.  Usón, J.V. Tejedo, and M.A. Vives. 1992. Thérapeutique laparoscopique. L’ovariectomie et la ligature des cornes utérines chez la chienne. Recueil de Médicine Vétérinaire. Special Endoscopie. 168:237–241.

10.  Usón, J., and M.A. Vives. 1992. Occlusion tubárica with clips. In: Uson, J. (ed.). Atlas of Technical Surgical for Stapler. Endoscopia Veterinaria, Madrid, España. 84–85.