Penile Amputation and Sheath Ablation in the Horse

OBJECTIVE: To report a surgical technique for penile amputation and sheath ablation in horses. Study Design-Retrospective study. Animals or Sample Population-Twenty-five adult geldings of various breeds with conditions requiring penile amputation and sheath ablation. METHODS: The medical records of horses that had penile amputation and sheath ablation were reviewed. Briefly, the technique involved en bloc resection of the skin and subcutaneous tissues of the inner and outer lamina of the prepuce and penile shaft. Resection of the penile shaft, proximal to diseased segments, and spatulation of the urethral mucosa was followed by fixation of the penis to the ventral abdomen and closure of the peripreputial skin over the ventral aspect of the penis and creation of a new mucocutaneous junction at the urethral orifice. RESULTS: Mild to moderate postoperative hemorrhage occurred in all horses. Partial dehiscence of the mucocutaneous junction occurred in 8 horses; all healed by second intention. Postoperative pain lasting 24 to 48 hours occurred in 7 horses; 1 required epidural analgesia for pain relief. Long-term follow-up was available for 8 horses; none had any long-term complications. CLINICAL RELEVANCE: Partial amputation of the penis with pexy to the ventral abdomen and revision of the peripreputial skin can be used as an alternative to en bloc resection and penile retroversion for lesions involving the free part of the penis and the prepuce. It requires smaller incisions and results in less alteration to the normal appearance of the external genitalia than retroversion techniques, while still allowing the surgeon to remove extensive portions of the penis and extirpate the regional lymph nodes.