Page 1487 - Cote clinical veterinary advisor dogs and cats 4th

756.e4 Paraphimosis

Paraphimosis Bonus Material Client Education
Sheet
Online
VetBooks.ir
ASSOCIATED DISORDERS
BASIC INFORMATION
• Balanoposthitis: inflammation of the glans penis development of an immature (hypoplastic)
prepuce that is not long enough to com-
Definition (balanitis) and preputial mucosa (posthitis) pletely cover the penis.
Inability to completely retract and maintain • Phimosis: inability to extrude the penis • Can be associated with a relatively stenotic
the penis within the prepuce from the prepuce (paraphimosis occurs 14 preputial orifice or with ineffective preputial
times more frequently than phimosis in the
Synonym dog)
Penile protrusion • Priapism: prolonged penile erection with or
Epidemiology without sexual arousal
SPECIES, AGE, SEX Clinical Presentation
• Young, intact male dogs > castrated male DISEASE FORMS/SUBTYPES
dogs; rare in cats • Acute paraphimosis (i.e., after a recent
• Diagnosis at 4 months to 13 years of age mating) usually resolves within 12 hours.
(average, 2.9 years) • Chronic paraphimosis (i.e., resulting from
early-age castration) may be intermittent or
GENETICS, BREED PREDISPOSITION continuous.
Boxer, Chihuahua, cocker spaniel, Doberman,
German shepherd, German short-haired pointer, HISTORY, CHIEF COMPLAINT
Great Pyrenees, Labrador retriever, poodle, and
mixed-breed dogs History may include early-age castration, recent
mating, penile or preputial trauma, masturba-
RISK FACTORS tion, balanoposthitis, neurologic disease, and/or
• Castration at an early age promazine tranquilizer administration.
• Developmental preputial anomalies
(e.g., small preputial opening, aplastic or PHYSICAL EXAM FINDINGS
hypoplastic prepuce, hypospadias, male • Protrusion of the penis from the prepuce:
pseudohermaphroditism) extent can vary from only the apex to the
• Infectious (e.g., transmissible venereal tumor, entire length of the penis.
balanoposthitis) • Penile mucosa may be erythematous, dry,
• Neurologic deficits associated with posterior inflamed, edematous, ischemic, and painful,
paresis (e.g., intervertebral disc disease which may lead to self-mutilation. Chronic PARAPHIMOSIS Ventral caudal abdomen of a long-
[IVDD], spinal tumors) protrusion may lead to excoriation and haired male dog; cranial is to the top of the image.
• Trauma (e.g., os penis fracture) subsequent cornification of the mucosa. After semen collection for an infertility evaluation, this
dog developed paraphimosis secondary to inversion of
CONTAGION AND ZOONOSIS Etiology and Pathophysiology the prepuce during detumescence. This was resolved
quickly with application of a topical lubricant to the
Transmissible venereal tumor preventing penile • Can be associated with early-age (<3 months penile mucosa near the preputial opening and then
retraction old) castration in dogs resulting in the gently sliding the prepuce over the swollen glans penis.

A B
PARAPHIMOSIS Phallopexy is a technique of creating a permanent adhesion between the dorsal surface of the
penis and the preputial mucosa. A, An incision is made through the dorsolateral aspect of the middle of the prepuce
into the preputial cavity. B, The penis is visualized and then exteriorized through the incision.

www.ExpertConsult.com