Page 567 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

542 CHAPTER 2

VetBooks.ir CONDITIONS OF THE PENIS AND PREPUCE

Clinical presentation
PHIMOSIS
Careful examination and palpation of the swollen
Definition/overview structure reveal that swelling is limited to the pre-
Phimosis is the inability of the penis to be exterior- puce. Digital palpation usually reveals the tip of the
ised or protrude from the prepuce. penis within the prepuce. If the swelling has been
chronic, the skin may be ulcerated, sloughing or
Aetiology/pathophysiology infected.
Normal phimosis occurs in newborn colts whose
penis is adhered to the internal prepuce for the Differential diagnosis
first 4–6 weeks of life. Pathological phimosis usu- Swelling and prolapse of the prepuce should be dif-
ally occurs secondary to swelling and oedema fol- ferentiated from involvement of the penis by exami-
lowing trauma, such as a kick from a mare during nation. The cause of the swelling may be unrelated
breeding (Fig. 2.145). Phimosis may also occur to the penis, prepuce or scrotum, with the phimosis
with conditions that cause inflammation of the being secondary.
penis, scrotum and prepuce such as coital exan-
thema, dourine and neoplasia. Any animal with Management
significant ventral oedema from any cause may Oedema and swelling of the prepuce are treated by
have severe oedema of the scrotum and prepuce, a combination of exercise, cold hydrotherapy (15–20
resulting in prolapse of the internal prepuce and minutes every 4 hours), local massage, anti-inflam-
trapping of the penis within the narrowed pre- matories and diuretics. In severe cases, placement
putial ring. Once swollen, the effects of gravity of a sling to reduce gravitational effects is helpful
worsen the oedema and result in more preputial in relieving oedema (Fig. 2.146). Vaseline or other
prolapse, swelling and oedema. emollient dressings should be applied to help reduce

2.145 2.146

Fig. 2.145 Severe preputial swelling and phimosis Fig. 2.146 Sling applied to reduce the effects of
in a stallion following an accident while mounting a gravity on an oedematous scrotum and prepuce.
phantom with the artificial vagina affixed inside. The The rubber tubing is placed over the back and
stallion had mounted the phantom aggressively and additional tubing is run between the hindlimbs and
the prepuce became pinched between the edge of the tied over the back.
artificial vagina and the phantom, resulting in trauma.