VSR 421: Regional Veterinary Surgery (2+1)

ACQUIRED CONDITIONS

• The testis/testes may be affected by acquired diseases like orchitis, testicular trauma and testicular tumours.
• Orchitis, the inflammation of the testis, may result from infection of the testicular tissue. The usual route of infection is through the vas deferens from an infected urethra, prostate or urinary bladder. The infection may also reach the testis by a haematogenous route or via a penetrating injury through the scrotal skin.
• The condition may be unilateral or bilateral and may be acute in onset or chronic. In acute cases the animal may show pain, tenseness and scrotal oedema. Systemic signs of infection like leukocytosis, fever, anorexia and listlessness may also be seen. The testis appears enlarged and later may get adhered to its tunics. In chronic cases, abscesses may develop which may drain through tracts onto the skin.
• Acute cases may be treated using appropriate antibiotics, anti-inflammatory/analgesic agents and cold application. In cases of accumulated pus, incisional drainage will be useful in hastening the healing process. Cases that do not respond to conservative measures and are severe or chronic may be treated by orchiectomy.
• Trauma of the testicles may result following fights, accidents or attack by man. However, the condition has a low incidence considering the relatively exposed nature of the organs. The affected animal may have swelling of the testis, signs of local pain and even lameness of the hind limbs. Scrotal swelling, bruising and haematoma may be seen in more severe cases.
• The tunica albugenia may be ruptured and the testicular tissue may protrude through to variable degrees. Damage to testicular tissue, epididymus and spermatic cord may result in life threatening haemorrhage. Damage to the testicular tissue may lead to temporary or permanent infertility, spermatic granuloma formation due to the antigenic nature of the sperms or immune mediated orchitis.
• Mild cases may be treated using local cold application, systemic anti-inflammatory/analgesic agents and antibiotics when possibility for infection is suspected. In cases of severe trauma it is recommended to surgically open the scrotal sac and explore to assess the degree of damage to the testicle.
• Any bleeding present should be arrested appropriately. In case of rupture of tunica albugenia with resultant protrusion of testicular tissue, the protruding tissue should be excised and the tunica albugenia sutured with synthetic absorbable suture material. After closure of the skin incision a course of antibiotic should be administered. In cases of extreme irreparable cases of testicular trauma or unresponsive immune-mediated orchitis, orchiectomy may be the treatment of choice.
• Tumours of the testicle are common in old dogs. The most common are interstitial cell tumours, seminomas and Sertoli cell tumours. Signs include increase in size and firmness of the testicle/testicles, nodular induration on palpation, pain and signs of feminization in cases of Sertoli cell tumours.
• The condition should be differentiated from other conditions that can cause an enlargement of the testis or the scrotum like orchitis, torsion of the spermatic cord, testicular/associated tissue trauma, epididymitis, spermatocele, scrotal neoplasms and scrotal hernia. Diagnosis may be confirmed by FNAB or excisional biopsy. Orchiectomy is the treatment of choice.

Testicular tumor	Testicular tumor	Testicular tumor exposed through skin incision
Testicular tumor operative procedure 1	Testicular tumor operative procedure 2	Testicular tumor operative procedure 3

Skin closure