Priapism in the stallion

A review of the literature is given concerning the anatomy and pathophysiology of the equine penis with regard to priapism: a prolonged erection of the penis not associated with sexual arousal. Several treatment options, such as flushing of the corpus cavernosum penis with heparinized saline and the creation of shunt between the corpus cavernosum penis and the corpus spongiosum penis are discussed. Subsequently, a case of priapism in a stallion following the injection of acepromazine, is discussed. The priapism resolved after the corpus cavernosum penis was flushed with the stallion under general anaesthesia.     

Priapism after castration in a cat

Priapism developed in a cat 2 days after castration and strangury. The priapism was unresponsive to massage and antimicrobial treatment. Because of penile engorgement and necrosis, a perineal urethrostomy was performed. Clinical signs of priapism resolved after urethrostomy. Histologic examination of tissues revealed vascular stasis within the corpus cavernosum penis and funiculitis of the right spermatic cord.     

Surgical Treatment of Priapism in a Stallion

Priapism occurred in a stallion after the administration of acetylpromazine. When conservative measures failed, the corpus cavernosum penis (CCP) was drained and irrigated, and a vascular shunt between the erectile bodies was created. Subsidence of erection resulted, but subsequently, the stallion was unable to retract or erect the penis. The stallion was castrated and the penis was surgically retracted into the sheath.     

Treatment of Intraoperative Persistent Penile Erection in a Stallion

This case report describes the occurrence of persistent penile erection in a breeding stallion that occurred while the horse was under inhalant anesthesia for a carpal arthroscopy. The horse had no history of breeding problems, and no abnormalities were detected on physical examination, complete blood count, or serum chemistry tests performed prior to surgery. Anesthesia was induced with guaifenesin and ketamine after sedation with xylazine and was maintained with isoflurane in 100% oxygen. Penile erection developed approximately 35 minutes after induction and persisted for over 2 hours despite various physical and pharmacological attempts to alleviate it (massage, cold compresses, intravenous benztropine administration, and intracavernosal phenylephrine). Successful resolution of the erection was obtained by cannulation and drainage of blood from the corpus cavernosum and subsequent irrigation with heparinized sterile saline and infusion of phenylephrine in the corpus cavernosum. The detumescent penis was placed back into the sheath, and purse string sutures were placed in the sheath to ensure the penis would remain inside the sheath during recovery. The stallion's recovery from anesthesia was uneventful, the sutures were removed, and the horse was fitted with a penile sling to prevent additional edema or trauma. The stallion recovered completely from the persistent penile erection. Semen was collected 6 days after the event, and he returned to normal pasture breeding 6 weeks after surgery.     

Arterial supply of the penis in the New Zealand rabbit (Oryctolagus cuniculus L.)

In the present study, the distributional pattern of the penile artery and the vessels joining the blood supply of the penis were investigated in the New Zealand rabbit. Eight adult rabbits were used in the study. In order to exhibit the vascular network by dissection, latex was injected via the abdominal aorta. The main vessel which supplies blood to the penis, the penile artery, is a branch of the internal pudendal artery. It divides into two branches which form the deep and dorsal penile arteries at the level of the ischiadic arch. The deep penile artery penetrates the tunica albuginea, and forms the arterial network of corpus cavernosum penis. On the other hand, the dorsal penile artery gives off three small branches for the subischiocavernosus muscle and at the level of the attachment of this muscle sends two small branches for the preputium. The course of both arteries follows the dorsolateral surface of the penis to the glans and ends in an anastomosis. Hence, a caudal branch of the prostatic artery which originates from the umbilical artery joins the blood supply of the penis in the rabbit. After vascularizing the prostate complex, it ends by entering the corpus spongiosus penis at the dorsolateral surface at the level of the ischiadic arch.     

Arterial supply of the penis in agoutis (Dasyprocta prymnolpha, Wagler, 1831)

The arterial vascularization of agoutis’ penis (Dasyprocta prymnolopha) were analysed using ten male adults from ‘Núcleo de Estudos e Preservação de Animais Silvestres da Universidade Federal do Piauí’ (FUFPI/IBAMA n° 02/99). Among the total number of specimens, six animals had natural death and were members of the research collection of the Laboratory of Anatomy, and four were killed after anaesthesia. Stained bi‐centrifugated‐Cis‐I‐4 latex was injected in arterial vessels responsible for penis vascularization throughout the abdominal portion of aorta. The samples were fixed in 10% formaldehyde solution and arteries were dissected. The penile artery is originated as a branch of internal pudendal artery. At the level of ischiatic arch, the penile artery project two branches, the penile dorsal and the deep arteries; those arteries irrigates the penile dorsal surface and the corpus cavernosum penis. The penile dorsal arteries have an independent course up to the glans penis. Based on the conditions of this work a remarkable similarity regarding the distribution of vessels destined to the agouti penis when compared to other domestic, wild and lagomorph rodents as rabbits.     

Perineal incision into the corpus spongiosum penis to resolve persistent post urination haemorrhage after partial phallectomy

Partial phallectomy or en bloc resection are surgical methods to address pathological conditions of the penis and/or prepuce including neoplasia, trauma, habronemiasis, chronic paraphimosis or permanent penile paralysis, and priapism. Haemorrhage associated with urination is a common complication observed after penile surgery but usually resolves spontaneously without specific treatment. This report describes a case of post urination haemorrhage (PUH) that recurred with each urination and persisted without significant improvement for a period of 2 weeks following en bloc resection of the penis and the prepuce. A perineal incision (PI) into the corpus spongiosum of the penis (CSP) resolved PUH by decreasing the blood pressure in the CSP distal to the PI. We propose that PI of the CSP can be an effective method to address PUH after penile surgery and may decrease time of hospitalisation for horses affected with PUH after phallectomy procedures.     

The effect of a surgically created shunt between the corpus cavernosum penis and corpus spongiosum penis of stallions on erectile and ejaculatory function

OBJECTIVE: To evaluate the effect of a shunt created between the corpus cavernosum penis (CCP) and corpus spongiosum penis (CSP) on erectile and ejaculatory function of normal stallions and to verify persistence of the shunt. STUDY DESIGN: The capability of stallions to develop an erection and to ejaculate was evaluated before and after creation of a corporeal shunt. Persistence of the shunt was determined by dye injection into the CCP at necropsy. ANIMALS: Six stallions. METHODS: A CCP-CSP shunt was created in five stallions. Semen was collected before and 4 to 14 weeks after surgery, before the horses were euthanatized. Dye was injected into the CCP to determine persistence of the shunt. Dye was also injected into the CCP of a control stallion. RESULTS: All stallions had normal erectile and ejaculatory function before and after surgery. Dye, injected into the CCP, entered the CSP in three of five treated stallions, demonstrating persistence of the shunt, whereas in two stallions, dye was found only in the CCP, indicating closure of the shunt. No dye was detected in the CSP of the control stallion. CONCLUSIONS: Creation of a corporeal shunt does not interfere with normal erection and ejaculation of stallions. Shunt closure is not necessary for stallions to retain normal erectile and ejaculatory function. CLINICAL RELEVANCE: Failure of a stallion affected by priapism to achieve normal erection or to ejaculate after creation of a corporeal shunt would likely be because of damage to corporeal tissue than from an effect of the shunt.     

Cavernosography and differential diagnosis of impotence in the bull

A new indirect radiographic technique is described for the differential diagnosis of erectile impotence in the bull. Two cases of impotence have been investigated in this way. In the first, occlusion of the dorsal longitudinal canal of the corpus cavernosum penis in an 18-month-old Hereford bull was diagnosed. In the second, distal venous drainage of the corpus cavernosum penis was demonstrated in a five-year-old Hereford bull. Post mortem examination of the reproductive tract confirmed the diagnosis in each case.     

Impotence in the bull: (3) Rupture of the corpus cavernosum penis proximal to the sigmoid flexure

Penile haematomas, lying outside the tunica albuginea, were found in six bulls of various breeds, aged one-and-a-half to nine-and-three-quarter years. In five cases the haematomas definitely arose from rupture of the dorsal or crural canal and tunica albuginea of the corpus cavernosum penis (ccp) within the proximal 12 cm of the penile body. In the sixth bull, lesions of the tunica albuginea and distortion of the penis just proximal to the proximal bend of the sigmoid flexure may have represented the site of rupture. There was no evidence of rupture at the distal bend of the sigmoid flexure or of rupture of the dorsal penile vessels in any of these specimens. In all six specimens, the dorsal canals of the ccp were occluded by translucent fibrous tissue distal to the sites of rupture; this was considered to be the factor immediately predisposing to proximal rupture of the ccp. Clinically, a small haematoma in the perineal region is difficult or impossible to palpate externally. However, when the haematoma of proximal origin is large, differentiation from rupture at the distal bend of the sigmoid flexure may be based tentatively on a careful clinical examination. In cases of proximal rupture the haematoma lies caudal and dorsal to the scrotum and no abnormality of the distal bend may be palpable. In cases of distal rupture, the haematoma usually lies cranial to the scrotum and involves the distal bend of the flexure. Severe disruption of the vascular structure is found in cases of proximal rupture of the ccp; therefore the prognosis is grave.     

Preputial hematoma in a stallion

An 8-year-old Quarter Horse stallion was admitted with a swelling involving the prepuce, dorsal part of the scrotum, and root of the penis. The swelling was first noticed 10 days after breeding, with no evidence that it had resulted from a kick by the mare. The penis was retracted into the prepuce, except for a 10- to 15-cm protrusion of the glans penis. Treatment included warm hydrotherapy, massage, stockinette compression, antidiuretics, antibiotics, penile support, and exercise, without success. At necropsy, a massive preputial hematoma was found extending forward from the root of the penis to 12 cm proximal to the glans penis. The exact origin of the hematoma could not be determined. Most likely, bleeding had originated from the vascular plexus lying subfascially on the surface of the penis outside the intact tunica albuginea or from a branch of the external pudendal artery.     

Manually assisted ejaculation in a stallion with erectile dysfunction subsequent to paraphimosis.

A Thoroughbred stallion with erectile dysfunction following paraphimosis was managed to allow consistent ejaculation. Ejaculation was elicited in this stallion by applying manual stimulation to the base of the penis. This technique allowed consistent ejaculation, and the stallion was able to return to natural service. Historically, stallions with this degree of penile dysfunction have been considered incapable of ejaculation and unable to continue as breeding animals.     

Priapism in seven cats

Priapism (persistent and painful erection) is an uncommon disorder in cats and dogs. This report describes the clinical and pathological features of seven cases of priapism in cats. Six of the cases were Siamese cats, and in four of them the priapism developed after attempted mating with an oestrus female, despite three of them having been neutered. Five cats were treated by perineal urethrotomy, which was successful in four. In five of the six amputated specimens, thrombosis of the corpus cavenosum was evident.     

Impotence in bulls due to vascular shunts from the corpus cavernosum penis

Eleven bulls were determined to be impotent due to vascular shunts from the corpus cavernosum penis to the extracorporeal circulation. Clinically, the bulls were unable to achieve erection when stimulated with an electroejaculator and in natural breeding trials. The vascular shunts were located by serial contrast radiography of the corpus cavernosum penis. Surgical correction of the shunts was attempted in 8 of the bulls by wedge resection of the tunica albuginea. In 4 bulls, the surgical correction was successful and the bulls were returned to service.     

Priapism Associated with Lumbar Stenosis in a Dog

Priapism, a persistent long‐lasting involuntary erection of the penis, is uncommon in dogs. In this report, the case of a 13‐year‐old male Pointer, referred to our services due to persistent exposition of the penis, is described. This condition was consecutive to an intermittent priapism situation lasting for several days, which has been initially attributed to the inflammation and haematoma associated with a perianal bite. The owners became unable to retract the penis into the prepuce. At presentation, the dog was anorectic for 48 h, intolerant to manipulation, and showed poor body condition and unsteady locomotion. During physical evaluation, a marked engorgement of the local vessels in the prepuce and penis was found. An abdominal X‐ray was asked under the suspicion of a neurogenic origin for the clinical situation, which showed evidences of spondylosis. After discussion of the clinical condition, the owners asked for euthanasia. The necropsy confirmed the engorgement of the regional vessels deriving from the pudendal arteries and blood accumulation within all the cavernous spaces, accompanied by congestion and thrombosis within the erectile structures of the penis. No significant changes were observed in the pelvic organs that could be at the origin of priapism. The lumbar‐sacral spinal regions were carefully inspected and evidenced signs of L7‐S1 stenosis due to spondylosis. The case presented herein is a rare situation of priapism of neurogenic origin in a dog. Necropsy findings suggest that it was consecutive to cauda equina compression due to lumbar spinal stenosis.     

Priapism Secondary to Perineal Abscess in a Dog – A Case Report

A 7‐year‐old intact male Boxer was referred to our services at the Veterinary Teaching Hospital of the University of Trás‐os‐Montes and Alto Douro, suffering from a persistently erect penis (including the bulbus glandis) that had been exposed for several days. Radiographic and ultrasonographic examinations detected a 5.0 × 3.5 cm mass located dorso‐laterally to the urinary bladder. The microbial culture of the mass revealed Staphylococcus spp. At that time, we suspected the involvement of an abscess in the origin of the priapism. Medical and surgical treatments were promptly instituted, which allowed for penile withdrawal into the prepuce; however, the resolution of the penile erection was not accomplished in the following days and penile amputation was required. Histological evaluation of the excised penis revealed extensive infarction of the erectile tissue of the pars longa and bulbus glandis, and also of the blood vessels of the penis. Following penile amputation and antimicrobial therapy, the animal fully recovered. Ultimately, the animal died as a consequence of gastric torsion. At necropsy, some lesions compatible with a previous perforation of the intestinal wall were recorded. The data gathered from the anamnesis, the physical and imaging examinations, along with the post‐mortem findings, allowed us to conclude that in this clinical case the primary cause of priapism was a perineal abscess due to bowel perforation.     

Hematochezia in an African spurred tortoise (Centrochelys sulcata)

An African spurred tortoise (Centrochelys sulcata) that had been housed with a conspecific was presented for tenesmus, diarrhea, and hematochezia of 48 hr duration. Husbandry was considered substandard. Hematology and plasma biochemical analysis revealed dehydration. Urinalysis was considered normal and fecal examination was negative for parasitic ova and protozoa. Radiography demonstrated moderate constipation. Initial treatment consisted of fluid therapy, enrofloxacin, metoclopramide, and improvement of husbandry practices. Recurrence of hematochezia developed 2 wk after initial presentation. Cloacoscopy followed by manual exteriorization of the penis revealed a puncture wound on the dorsal surface of the corpus cavernosum proximal to the glans penis. The wound was sutured using an absorbable monofilament material. The tortoise recovered uneventfully and was asymptomatic for the following 6 mo.     

Arginase alteration in the reproductive system of alloxan-diabetic dogs

This study was conducted to evaluate possible alteration in the activity of arginase, an important enzyme of cell proliferation and vascular smooth muscle contraction regulator in diabetics, that may be correlated with low fertility in diabetic patients. In this investigation, 6 apparently healthy adult male dogs were selected and divided in two groups, diabetics and non-diabetics. Diabetes mellitus was induced in one group by intravenous (IV) injection of alloxan (100 mg/kg). Dogs with a fasting blood glucose (FBS) of more than 200 mg/dl were considered to be diabetic. Four weeks following induction of diabetes mellitus, the animals in both groups were anesthetized by an IV injection of sodium thiopental. Livers and whole reproductive systems, including the testes, penis, urethra, and prostate, were dissected. The epididymides, corpus cavernosum, corpus spongiosum, penile urethra, and vas deferens were also dissected and removed from the reproductive system. Arginase activity and total protein were measured by the urea and Lowry's methods respectively in above mentioned sections. Plasma testosterone was determined by the radioimmunoassay method. The results showed significantly (P<0.05) increased arginase specific activity (ASA) in the liver, epididymis, prostate, corpus cavernosum and corpus spongiosum of the diabetic dogs. In the reproductive system of the diabetic dog, the maximum and minimum ASA was seen in the corpus cavernosum and testes, respectively (105.12 +/- 8.76 vs. 25.0 +/- 0.55). No such variation was observed in the ASA of normal dogs (39.0 +/- 5.47 vs. 25.0 +/- 5.47). There was no significant difference in plasma testosterone level between the groups. In conclusion, diabetes increased the ASA in liver, prostate, epididymis, corpora cavernosa, and corpora spongiosum of the male dogs and may contribute to erectile dysfunction or low fertility in diabetics.     

Penile vascular system of the dog. An injection-corrosion and histological study

The vascular architecture of the dog penis was studied by resin casts and histological preparations. Morphological evidence was found for penile engorgement. The crus and the bulb were compressed by the ischiocavernosus and the bulbospongiosus muscles, respectively, indicating that these muscles act as a booster pump. The distal part of the bulb was also strangulated by the external anal sphincter, indicating that this muscle prevents blood in the corpus spongiosum penis from going back into the bulb. The common trunk of the dorsal vein of the penis was significantly occluded by the ischiourethralis muscle. The internal pudendal vein was also throttled by the levator ani, the coccygeus, and the internal obturator muscles. The extremely narrow diameter of each vein draining the erectile body was insufficient to drain the increased blood flow and, therefore, formed a sluice channel. It is inferred that these muscle activities and sluice channels facilitate the erection of the penis.     

Urethral Defects in Geldings With Hematuria and Stallions With Hemospermia

A urethral defect, presumed to communicate with the corpus spongiosum penis, caused hematuria in seven geldings and hemospermia in three stallions. Hematuria in geldings occurred at the end of urination. Hematuria was not observed in stallions with hemospermia. A linear urethral defect was identified, by endoscopic examination, on the convex surface the urethra at the level of the ischial arch of each horse. Cause of the defect was not determined. Two stallions were successfully treated for hemospermia, one by temporary subischial urethrostomy combined with sexual rest for 10 weeks, and the other by sexual rest alone for 6 months. The third stallion had hemospermia 6 weeks after urethrostomy. The geldings were successfully treated for hematuria, six by temporary subischial urethrostomy, and one by a subischial incision that extended into the corpus spongiosum penis but did not enter the lumen of the urethra. Efficacy of subischial urethrostomy for treatment of hemospermia was difficult to assess because of the small number of surgically treated stallions. In geldings, surgery eliminated hematuria, presumably by reducing vascular pressure in the corpus spongiosum penis during urination, thus allowing the urethral defect to heal.