Page 213 - Manual of Equine Field Surgery

Penile Amputation 209

f

Figure 37-10 Fi11al appearance after performing

William's technique,

Figure 37-9 Intraoperative view of the initial suture

placed to close the corpus cavernosum,

mucosa in a simple continuous pattern with

absorbable suture material. The urethral mucosa

is then closed to the skin at the base of the trian-

gle in a simple interrupted or simple continuous

pattern using No. 2-0 monofilament absorbable

suture material (Figures 37-10 and 37-11).

POSTOPERATIVE CARE

Postoperative Care

Exercise Restridions: Stall rest with handwalk- Figure 37-11 Intraoperative view of final appear-

ing should be provided for 10 days, followed by ance after performing William's technique.

small-area turnout for 1 O days.

Medications: Phenylbutazone is administered at

4.4 mg/kg BID for the initial 24 hours and 2.2

mg/kg BID for an additional 3 days. Antibiotic Recurrence or metastasis of squan1ous cell carci-

theraRY is given perioperatively and for 3 to 5 days noma is a significant problem, and owners should

postoperatively. Horses should receive a tetanus be forewarned of this. Reported survival rates for

toxoid booster if it has been longer than 6 months squamous cell carcinoma include a 60o/o to 71 o/o

2'3
since the previous vaccination. survival rate of longer than 1 year. Involvement

Suture Removal: Sutures are absorbable but of the urethra decreases the prognosis; one study

can be removed T2 days postoperatively. shows only a 30% 18-month survival rate when

Other: Amputation is not usually performed on urethral tissue was involved. 2

stallions because of potential incisional problems.

Ideally, stallions should be gelded several weeks

before surgery. If the procedure is performed on COMPLICATIONS

a stallion, exposure to mares should be avoided

for 4 weeks. Artificial collection will be necessary

when breeding is resumed. Hemorrhage, dehiscence, urethral stricture,

minor swelling, and recurrence or metastasis of

neoplastic lesions are possible. Mild incisional

EXPECTED OUTCOME hemorrhage during urination may be common

during the first 2 to 3 days postoperatively.':' Per-

With appropriate hemostasis, complications sistent bleeding or hemorrhage that is dissecting

associated with the surgery are not common. into the incision line should be controlled surgi-