Standing urogenital surgery.

Caslick's, episioplasty, urethroplasty, cervical, and rectovestibular laceration repair are, by preference, performed in the standing patient. Normal castration is performed routinely uneventfully in the standing patient. The duration of the procedures and the ease with which they are accomplished in a standing horse of normal temperament make general anesthesia unnecessary. More invasive procedures, such as removal of urinary bladder calculi in male horses or removal of a neoplastic ovary in a mare, can be accomplished in a standing patient but serious consideration should be given to the use of general anesthesia. For these procedures, the potential complications are increased while the ability to effectively deal with those complications is diminished in a standing patient. For instance, imagine a mare that lays down in the stocks during a standing flank removal of an ovary or a stallion that defecates during a Gokel's approach to the bladder. Only extenuating circumstances justify these risks when general anesthesia is available.