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Basics ⬇

Outline

BASICS

Overview!!navigator!!

  • Penile traumatic injuries, including lacerations, are common in stallions
  • Lacerations to the penile surface or urethral process are often the result of trauma (jumping a barrier or during breeding), tail hair, poor handling during collection on a phantom, or a poorly prepared artificial vagina
  • Laceration may compromise the breeding activity or normal micturition

Signalment!!navigator!!

No age or breed predilection.

Signs!!navigator!!

  • Bleeding may be noticed from the prepuce
  • Severe cases are accompanied by inflammatory edema, cellulitis, and paraphimosis

Causes and Risk Factors!!navigator!!

  • Trauma—breeding accidents, improperly fitted stallion rings, kicks, jumping injuries, masturbation, and improper surgical technique
  • Aggressive stallions/colts housed or handled in unsafe conditions are more likely to injure themselves and others

Diagnosis ⬆ ⬇

Outline

DIAGNOSIS

Differential Diagnosis!!navigator!!

Differentiating Causes

  • Visual inspection generally reveals the laceration
  • Paraphimosis may be present, but may be secondary to the laceration
  • Ulcerative lesions caused by neoplastic or parasitic diseases should not be considered lacerations for this discussion

CBC/Biochemistry/Urinalysis!!navigator!!

May be indicated in complicated cases.

Other Laboratory Tests!!navigator!!

N/A

Imaging!!navigator!!

N/A

Other Diagnostic Procedures!!navigator!!

N/A

Treatment ⬆ ⬇

TREATMENT

  • Ensure urethral patency. Placement of a urinary catheter may be indicated
  • Cleanse and debride the wound as dictated by location and severity
  • Acute post-trauma lacerations can be sutured to achieve first intention healing
  • Old or grossly contaminated lacerations may have to heal by second intention, or delayed closure can be considered
  • Support the penis and prepuce with slings, hydrotherapy, and judicious exercise to prevent or eliminate extensive dependent edema
  • Sexual stimulation is absolutely contraindicated until healing is complete

Medications ⬆ ⬇

Outline

MEDICATIONS

Drug(s) of Choice!!navigator!!

  • NSAIDs including phenylbutazone (2–4 g/450 kg body weight/day PO) or flunixin meglumine (1.1 mg/kg/day IV, IM, or PO) for patient comfort and to decrease inflammation. High initial dosages should be titrated to the lowest effective dose if more than 5 successive days of therapy is required
  • Systemic or local antibiotics for local infections and to prevent septicemia, if indicated
  • Emollient application as required to the penile surface to prevent or address urine scalding, if indicated

Contraindications/Possible Interactions!!navigator!!

Phenothiazine tranquilizers should never be used in the intact male.

Follow-up ⬆ ⬇

Outline

FOLLOW-UP

Patient Monitoring!!navigator!!

  • If the penis can be maintained within the prepuce without support, less frequent evaluation is necessary
  • If retraction of the penis is not possible, hospitalization may be required for frequent evaluation and care of the exposed penis

Possible Complications!!navigator!!

  • Urine leakage with extensive tissue necrosis is possible if the penile urethra has been lacerated
  • Wounds that cannot be treated surgically are usually complicated by suppuration and cellulitis
  • Scar formation can result in phimosis, erectile dysfunction, impotence, or infertility
  • Hematomas generally arise from blood vessels superficial to the tunica albuginea. A hematoma that continues to enlarge is more likely attributable to a rent in the tunica albuginea, and closure of that defect is a priority
  • Paraphimosis is a common sequela to penile lacerations
  • Penile paralysis is possible as a result of the injury itself or secondary to paraphimosis

Miscellaneous ⬆ ⬇

Outline

MISCELLANEOUS

Associated Conditions!!navigator!!

  • Hemospermia
  • Impotence
  • Paraphimosis
  • Penile paralysis
  • Phimosis

Age-Related Factors!!navigator!!

N/A

Zoonotic Potential!!navigator!!

N/A

Pregnancy/Fertility/Breeding!!navigator!!

N/A

Abbreviations!!navigator!!

NSAID = nonsteroidal anti-inflammatory drug

Suggested Reading ⬆ ⬇

Ley WB, Slusher SH. Infertility and diseases of the reproductive tract of stallions. In: Youngquist RS, Threlfall WR, eds. Current Therapy in Large Animal Theriogenology, 2e. St. Louis, MO: Saunders Elsevier, 2007:15–23.

Schumacher J, Varner DD. Surgical correction of abnormalities affecting the reproductive organs of stallions. In: Youngquist RS, Threlfall WR, eds. Current Therapy in Large Animal Theriogenology, 2e. St. Louis, MO: Saunders Elsevier, 2007:23–36.

Schumacher J, Vaughan JT. Surgery of the penis and prepuce. Vet Clin North Am Equine Pract 1988;4:443–449.

Vaughan JT. Penis and prepuce. In: McKinnon AO, Voss JL, eds. Equine Reproduction. Philadelphia, PA: Lea & Febiger, 1993:885–894.

Author(s) ⬆

Author: Ahmed Tibary

Consulting Editor: Carla L. Carleton

Acknowledgment: The author and editor acknowledge the prior contribution of Carole C. Miller.