How can surgery help dogs with repeated bladder infections?

Bella, a 4 year old female Labrador, kept having bladder infections despite several rounds of antibiotics.

Her family vet at eventually diagnosed her with a redundant vulvar fold. This means that a simple exam of her back end revealed a little surprise: an extra fold of skin covering her vulva. This common condition is also called vulvar fold dermatitis or recessed vulva. My impression is that many dogs have this problem but haven’t been diagnosed yet.

A redundant vulvar fold

How on earth can an extra skin fold cause bladder infections?

The excess skin forms a pocket where urine gets trapped. The moist, warm and dark environment creates ideal breeding grounds for bacteria. This can cause a foul odor in addition to ongoing infections.

In addition, Bella became very reactive & even aggressive toward the other pets in the household.

Signs of bladder infections may include licking of the vulva, scooting of the back end, bloody urine, urinary incontinence and “accidents” in the house. Other conditions may cause similar signs, so your family vet should eliminate other problems, such as bladder stones and even bladder cancer.

So what is the treatment of this bizarre condition?

  1. The Band-Aid approach is the “medical” treatment. We treat the symptoms by cleaning the area and giving antibiotics. But we are not treating the cause, so it can be rather frustrating every time the infection comes back.
  2. The best treatment is surgery. Yes, we can do cosmetic surgery on a dog’s vulva. Call it nip and tuck! Surgery allows removing the excess skin in order to provide better ventilation to the area.

The reconstructive surgery is called a vulvoplasty or episioplasty. The main challenge of the surgery is to remove just the right amount of skin: not too much and not too little.


Recovery generally takes 2-3 weeks. I don’t place skin sutures, so there are no stitches to remove in this sensitive area… All stitches are internal and eventually dissolve. An E collar (plastic cone) is critical for the full 2-3 weeks to prevent licking and to protect the incision.

Overall, this is a common yet frustrating condition. Fortunately, surgery is typically successful and pet owners are usually very happy with the end result… as well as their dogs!


Bella’s owner wrote: “I am ecstatic to say… Bella has not had a bladder infection since surgery!!”

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Dr. Phil Zeltzman

Dr. Phil Zeltzman is a traveling veterinary surgeon in Pennsylvania & New Jersey. An award-winning author, he loves to share his adventures in practice along with information about vet medicine and surgery that can really help your pets. Dr. Zeltzman specializes in orthopedic, neurologic, cancer, and soft tissue surgeries for dogs, cats, and small exotics. By working with local family vets, he offers the best surgical care, safest anesthesia, and utmost pain management to all his patients. Sign up to get an email when he updates his blog, and follow him on Facebook, too!