Uterine Prolapse in Pigs: Incidence and Management
Incidence
The annualized incidence rate of uterine prolapse in sows is approximately 3.8 cases per 1000 sow-years, with nearly 1% (0.8%) of sows removed from production due to prolapses. 1
- The majority of prolapse cases (60.9%) occur during the first 0-4 weeks after farrowing 1
- Peak incidence occurs at 16 weeks after service, with rates 30.6 times higher than during the first 14 weeks 1
- Vaginal prolapse specifically accounts for 6.3% of dystocia cases in swine, while vesical flexion (bladder displacement) represents 3.1% 2
Risk Factors
Parity 3 or higher sows face 1.5-1.8 times higher prolapse risk compared to first-parity animals. 1
Key risk factors include:
- Parity: Sows in parity 3+ have significantly elevated risk, with 50% of vesical flexions and 78.8% of vaginal prolapses occurring around the third parturition 1, 2
- Re-service: 1.3 times higher incidence in re-serviced sows 1
- Season: Summer, autumn, and winter services carry 1.3-1.5 times higher risk than spring 1
- Gestational length: Shorter gestation (≤113 days) increases risk 1.3-1.5 times 1
- Litter characteristics: Fewer total piglets born (≤11) and two or more stillborn piglets each increase risk by 1.2-1.4 times 1
Clinical Presentation
Most prolapses (81.2% of vesical flexions and 72.7% of vaginal prolapses) are not presented until tissue displacement becomes stationary. 2
- Rectal tissue displacement accompanies 31.2% of vesical flexions and 21.2% of vaginal prolapses 2
- Differentiation between vesical flexion and vaginal prolapse requires catheterization of the bladder, performed in 56.2% of cases for both diagnostic and therapeutic purposes 2
Treatment Approach
Manual reduction followed by retention sutures represents the primary treatment strategy, with catheterization maintained for an average of 6 days (maximum 19 days) in vesical flexion cases. 2
Immediate Management:
- Manual replacement of prolapsed tissue 3
- Bladder catheterization using Foley catheter for vesical flexion cases 2
- Vaginal retention sutures (Bühner technique) applied in 60.6% of vaginal prolapse cases after reduction 2
Prevention Strategies:
- Enhanced monitoring of high-risk sows (parity 3+, re-serviced, summer/autumn/winter services) 1
- Early detection during the critical 16-week post-service period and first 4 weeks postpartum 1
- Attention to sows with shorter gestational lengths and higher stillborn rates 1
Common Pitfalls
Delayed presentation is the most significant management challenge, with most cases not receiving veterinary attention until tissue displacement becomes fixed. 2
- Failure to differentiate vesical flexion from vaginal prolapse without proper catheterization leads to inappropriate treatment 2
- Inadequate retention suture placement or premature catheter removal increases relapse risk 2
- Missing the critical monitoring window at 16 weeks post-service when incidence peaks dramatically 1