VSR 421: Regional Veterinary Surgery (2+1)

CONDITIONS AFFECTING THE PREPUCE AND SCROTUM

• Phimosis, inability to protrude the penis out through the prepucial orifice, may occur congenitally or may be acquired. A congenitally narrow prepucial orifice may prevent the protrusion of the penis.
• Acquired conditions like stricture of the prepucial orifice following trauma or due to the presence of prepucial tumours also cause phimosis. In cases in which the prepucial orifice is severely narrowed urine may be voided in a thin stream or in drops.
• Urine may get retained in the prepucial sheath and cause necrosis of the inner lining of the prepuce and the surface of the penis.
• Treatment involves surgical enlargement of the prepucial opening and suturing the prepucial mucosa to the skin all around the prepucial opening using fine monofilament suture material like nylon. The penis, if necrotic, may be cleaned with mild antiseptic solution and emollient antibacterial preparations administered.
• Prepucial abnormalities like hypoplasia, agenesis or failure to fuse ventrally may also be seen congenitally or defects may arise following trauma. Cases of incomplete fusion of the prepucial folds may be treated by scarification of the edges and suturing when the defect is small.
• In cases where the prepuce is not sufficiently developed/remaining to allow reconstruction, amputation of the exposed part of the penis may help. Orchiectomy, scrotal ablation and urethrostomy may have to be performed in cases in which the prepuce is extensively affected.
• Prepucial wounds may be acquired following fights, during mating, accidents or while jumping over barbed wire. Superficial wounds may be allowed to heal by second intention. Full thickness injuries may be sutured. The prepucial mucosa and the skin have to be sutured separately.
• Prepucial tumours include all type of tumours that affect the skin. TVT, melanomas, mast cell tumours and perianal gland tumours have been reported from the prepuce. Surgical treatment includes excision followed by suturing the skin and mucosa separately or partial penile amputation also in cases where extensive prepucial involvement is seen.
• Scrotal injuries, scrotal infection and scrotal tumours may be managed conservatively in mild cases by medical management or surgical excision followed by routine suturing. However, severe cases may warrant orchiectomy and scrotal ablation.