Preputial damage and lateral penile displacement during castration in a degu

CASE DESCRIPTION: A 2-month-old male degu was treated for preputial damage and lateral penile displacement that occurred during attempted castration. CLINICAL FINDINGS: Bruising and swelling of the prepuce and severe edema to the left of the prepuce were evident. The penis could not be extruded from the prepuce. Radiography revealed a large bladder. Contrast medium injected into the prepuce filled the peripreputial subcutaneous tissues. TREATMENT AND OUTCOME: During surgical exploration through a peripreputial approach, the penis was found to be completely separated from the prepuce and located in the adjacent subcutaneous tissue. The penis was repositioned in the prepuce and anchored with a suture at its base. The following day, the preputial orifice was crusted over, urine was leaking from the incision, and the penis could not be extruded from the prepuce. The anchoring suture was removed, and the tip of the penis was sutured to the preputial orifice so that the penis protruded slightly from the prepuce. Urination was normal after the second surgery. Two years later, the preputial orifice remained adhered to the distal portion of the penis and the exposed penile tissue was healthy. CLINICAL RELEVANCE: Penile displacement from the prepuce is an unusual complication of castration in degus. The surgical technique used in this animal may be an effective means of repair. Permanent exposure of the tip of the penis may be well-tolerated in degus.     

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 The penis was retracted into the prepuce, except for a 10- to 15-cm protrusion of the glans penis.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.     

Surgical treatment of 45 horses affected by squamous cell carcinoma of the penis and prepuce

The medical records of 45 horses treated for suspected squamous cell carcinoma of the penis and/or prepuce were reviewed. The age of 40 horses was known, and these had a mean age of 17.4 years. The duration of neoplasia was known for only 3 of the 45 horses. The results of histological evaluation of lesions, available for 35 horses, confirmed that the diseased tissue was squamous cell carcinoma. The location of gross neoplastic lesions was recorded for 43 horses; the glans penis was involved in 24 horses, the body of the penis or the inner lamina of the preputial fold in 27 horses, and the external fold of the prepuce in 10 horses. Surgical treatments of these horses included phallectomy (penile amputation) in 35 horses, segmental posthectomy in 4 horses, phallectomy plus segmental posthectomy in 2 horses, and en bloc resection of the penis, prepuce and superficial inguinal lymph nodes with penile retroversion in 4 cases. Short-term complications in the immediate postoperative period included preputial oedema and haemorrhage at the end of urination. One horse developed acute urinary retention because of severe urethral oedema. Long-term (>1 year) follow-up information was obtained for 31 horses. Neoplasia of the penis and/or prepuce recurred in 6 of these 31 horses (19%), and in 5 of these the recurrence necessitated euthanasia of the horse.     

Phimosis and paraphimosis in two ferrets (Mustela putorius furo)

Cases of paraphimosis are rarely described in ferrets. Phimosis has not been reported in the ferret. Two castrated ferrets with abnormalities of the prepuce were presented separately. Case 1 had a 4-month duration of a non-reducible paraphimosis. A shortening of the sheath prevented complete covering of the penis. Case 2 had dermatitis around the prepuce of a month's duration. The foreskin was distended by urine which could be eliminated through a barely visible opening by the application of manual pressure. The penis could not be extruded under general anesthesia. Surgery was performed in both cases. In case 1, parts of the skin of the prepuce, and mucosa of the sheath were resected to create an enlarged opening correcting the constriction of the penis. In case 2, a circular incision was made along the periphery of the skin with dermatitis, and the skin of the prepuce. The skin was resected to enlarge the preputial orifice. Surgical treatment was successful in both cases, did not present any technical difficulties, and was of a short duration. Surgical treatment of paraphimosis and phimosis have not been reported in ferrets and should be considered in cases of scalding of the prepuce not responding to medical treatments.     

Preputial foreign body in a bull

A preputial foreign body caused severe preputial swelling and depression in a 4-year-old Shorthorn bull. Disruption of the preputial epithelium by the foreign body resulted in abscess formation lateral to the prepuce. A patent urethral fistula, probably a complication of prior fibropapilloma excisional surgery, was also detected on the distal portion of the glans penis. Foreign body removal, antimicrobial administration, and warm hydrotherapy resolved the swelling and abscess. Electroejaculation was used to extend the penis and to minimize preputial adhesions. Breeding soundness examinations were used to evaluate breeding potential.     

Surgical treatment of phimosis due to preputial stenosis in a Thoroughbred colt

A 6-month-old Thoroughbred colt was referred to Rossdales Equine Hospital with a recent history of discomfort and inability to protrude the penis whilst urinating, resulting in accumulation of urine within the prepuce. Careful examination and manual palpation revealed a constrictive ring of fibrous tissue at the level of the preputial orifice. With no evidence of trauma or a persistent penile frenulum, a tentative diagnosis of phimosis due to congenital preputial stenosis was made. Exploratory surgery confirmed the diagnosis and surgical transection and release of the fibromuscular ring at three sites allowed the colt to protrude the penis and urinate normally immediately post-operatively. At follow-up examination 11 months later, the colt continued to be able to extrude the penis and urinate conventionally. A slight excess of skin was present at the end of the prepuce but this was only of minor cosmetic concern.     

Surgical treatment of paraphimosis in a pony

Circumcision (or reefing operation) was performed on an aged pony stallion to remove excessive granulation tissue involving the preputial integument following an injury and subsequent paraphimosis. Postoperative swelling of the penis and prepuce was reduced daily with gentle massage. Initially, an improvised suspensory was used to support the penis postoperatively. The pony was able to voluntarily retract its penis six months following surgery.     

Use of a preputial circumferential mucosal flap for hypospadias management in a Boston terrier

An eight-week-old male Boston terrier presented for penile desiccation and urine pooling in the prepuce due to congenital hypospadias. An advancement flap was created from the dorsal mucosa of the incompletely formed prepuce and sutured circumferentially to construct a longer distal preputial mucosa. V- to Y-plasty of the ventral abdominal skin was utilised to create the preputial skin overlying the mucosal flap. Urethrostomy and partial penile amputation were also performed. Following surgery, the clinical signs of penile desiccation and preputial urine pooling resolved and acceptable cosmetic appearance was achieved. This technique may be considered for glandular or penile hypospadias or following resection of the ventral aspect of the distal prepuce when inadequate tissue is present for a simple two-layer closure of the preputial mucosa and skin.     

Metastatic transmissible venereal sarcoma in a dog

An adult male dog with large penile sheath and serosanguineous exudate from the preputial orifice and a cutaneous fistula in the right inguinal area was examined. Necropsy revealed tumor masses on the penis and prepuce, in superficial inguinal and external iliac lymph nodes, and in the liver. Histopathologic diagnosis of the tumor was confirmed by transplantation studies.     

Congenital phimosis in a cat

An 8-week-old domestic shorthair cat was presented with a history of pollakiuria and polydipsia. No abnormalities were detected during the clinical examination other than the penis could not be extruded from the prepuce. Urine culture demonstrated a growth of E. coli, which was treated with a prolonged course of amoxycillin. The polydipsia resolved and the pollakiuria improved but did not completely abate after antibiotic treatment and the cat had occasional bouts of haematuria. Because of the history of pollakiuria and polydipsia and the ongoing, occasional bouts of haematuria, the cat underwent surgical correction of the congenital phimosis. A small wedge of the dorsal prepuce was removed and the ipsilateral edges of the prepuce were apposed using a simple interrupted pattern. The procedure was quick, easy to perform and led to a resolution of the occasional bouts of haematuria and pollakiuria.     

Combined preputial advancement and phallopexy as a revision technique for treating paraphimosis in a dog

A 7‐year‐old neutered male Jack Russell terrier‐cross was presented for signs of recurrent paraphimosis, despite previous surgical enlargement of the preputial ostium. Revision surgery was performed using a combination of preputial advancement and phallopexy, which resulted in complete and permanent coverage of the glans penis by the prepuce, and at 1 year postoperatively, no recurrence of paraphimosis had been observed. The combined techniques allow preservation of the normal penile anatomy, are relatively simple to perform and provide a cosmetic result. We recommend this combination for the treatment of paraphimosis in the dog, particularly when other techniques have failed.     

Preputial urinary diversion to treat urine soaking during urination in a dog

A young dog was presented with a history of adopting an unusual posture to urinate, resulting in urine soaking of the ventral abdomen and caudal forelimbs. The dog was initially treated surgically with cranial advancement of the prepuce, which did not resolve the problem. Further surgery was then successfully carried out to create a more caudal preputial orifice, which angled the penis ventrally when extruded, directing urine away from the body. At follow-up clinical examination, the dog was clinically normal.     

Glomangioma in the Prepuce of a Dog

A case of preputial glomangioma in an 8-year-old Springer Spaniel dog is reported. The dog presented a solitary nodular mass, approximately 3.5 x 5.2 cm in diameter, located on the lateral wall of the prepuce at the base of the penis. Histologically, the excised tumour mass consisted of proliferating round epithelioid cells arranged in a cordon-like structure around small blood vessels. The neoplastic cells were positive for alpha smooth muscle actin and negative for cytokeratin, desmin, S-100 protein and neurone-specific enolase. Based on these pathologic features, the tumour was diagnosed as glomangioma, a neoplasm extremely rare in dogs. To our knowledge, this is the first report of preputial glomangioma in the dog.     

Direct preputial hernia associated with a ventral abdominal wall defect in a two‐year‐old gelding

The case of a 2‐year‐old gelding with acute onset of preputial swelling and prolapse is presented. After initiating conservative management using a penile repulsion device, the horse repeatedly displayed signs of mild abdominal discomfort with sudden deterioration to an episode of violent colic after 5 days of hospitalisation. Ultrasonographic examination of the preputial swelling at that time demonstrated the presence of small intestine between the internal and external laminae of the prepuce and led to the diagnosis of a direct preputial hernia. The contents of the hernia were readily reduced through a defect in the ventral abdominal wall after the anaesthetised horse was placed in dorsal recumbency. The historical information, clinical progression and surgical findings were supportive of an acquired ventral abdominal wall defect. To the authors' knowledge, this is the first reported case of a direct preputial hernia associated with an acquired ventral abdominal wall defect.     

Chronic prostatitis, cystitis, pyelonephritis, and balanoposthitis in a cat

An adult, intact male domestic shorthair presented for preputial swelling and urinary incontinence. A caudal abdominal mass was palpated. A transabdominal ultrasound examination showed severe prostatomegaly with abnormal tissue extending along the urethra. The cat was euthanized due to the owner's financial constraints and the veterinarians' suspicion of a poor long-term prognosis. Biopsies showed chronic active inflammation of the prostate, bladder, kidneys, ureters, penis, and prepuce most consistent with a chronic infectious process. Reports of feline prostatic disease of any kind are rare. Chronic prostatitis may have a more favorable prognosis than feline prostatic adenocarcinoma, currently the most commonly reported disease of the feline prostate.     

Surgical repair of urethral transection in a horse

A recently castrated horse was examined because of preputial and ventral abdominal swelling, prolapse of the preputial fold, and serosanguinous fluid dripping from the external urethral orifice. After a poor response to initial medical management, a urethral laceration was found during exploratory surgery. Half of the ventral portion of the corpus cavernosum penis had been transected. Primary closure was followed by healing without complications.     

Application of preputial tube-flap urethroplasty to establish a neourethra in a male dog with complications after preputial urethrostomy

A 14-year-old male poodle weighing 7.5 kg presented due to complications after preputial urethrostomy for management of preprostatic urethral rupture. Revision surgery was performed with preputial tube-flap urethroplasty via preputiotomy. A longitudinal flap was raised from the prepuce and anastomosed to the end of the previously cut urethra to create a neourethra and reduce tension at the urethrostomy site. Follow-up retrograde positive contrast urethrography performed 10 days and 6 months postoperatively showed no contrast leakage from either the neourethra tube flap or new preputial urethrostomy. A follow-up email questionnaire, based on the American Urological Association Symptom Index, was completed by the owner 6 months after surgery. The dog had excellent symptom scores, and urinated from the prepuce without difficulty in a manner resembling physiological urination.     

Phallopexy for treatment of paraphimosis in the dog.

Three dogs with recurrent paraphimosis were surgically treated by creation of a phallopexy between the dorsal surface of the penis and the corresponding surface of the prepuce. Follow-up evaluation was performed 4 to 31 months postoperatively. Treatment was successful in each case, and no dog had any adverse sequelae.     

Successful resolution of a preputial prolapse in an alpaca using medical therapy

A 2-year-old intact male alpaca was presented for a post-breeding preputial prolapse of 5 days duration. The internal lamina of the prepuce was prolapsed approximately 6 cm and the exposed preputial epithelium was edematous and necrotic. Following 7 days of medical treatment, resolution of the preputial prolapse was achieved.     

Causes of copulatory failure in beef bulls

A cow in full standing estrus is required to assess a bull's ability to copulate. Insufficient libido is not involved if the bull sniffs the cow's vulva and attempts to mount. Blood or pus exiting the penis or prepuce indicates penile or preputial lacerations or other lesions. Rear foot or stifle lesions, seminal vesiculitis, traumatic reticulitis or lumbar spinal injuries may prevent the bull from mounting. Preputial stenosis, penile adhesions, desensitization, hematomas or deviations, peripreputial abscess, cavernosal shunts, insufficient penile length and occlusions of the cavernosal canals may prevent intromission after mounting.