Page 568 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Reproductive system: 2.2 The male reproductive tr act 543

VetBooks.ir the effects on the preputial skin. Diagnosis and treat- Cases of priapism, if not treated immediately, may
also result in a secondary paraphimosis (see below).
ment of the underlying condition is essential. Rarely,
preputial resection (reefing operation) is required to
mise, oedema and impaired lymphatic drainage
remove permanently diseased tissue. Once prolapsed, a rapid cycle of vascular compro-
ensues. The effects of gravity on the pendulous penis
Prognosis further contribute to this cycle, eventually resulting
Phimosis caused by trauma carries a good progno- in necrosis of the skin and gangrene of the penis if
sis. The condition improves quickly following ini- left untreated.
tiation of therapy to reduce oedema and swelling
(Figs. 2.147, 2.148). Clinical presentation
The animal presents with a prolapsed penis that
PARAPHIMOSIS quickly becomes swollen. In cases of trauma, penile
abrasions will be obvious, and preputial oedema
Definition/overview may be also be evident (Fig. 2.149). Paraphimosis
Paraphimosis is the inability of the penis to retract may occur secondary to penile paralysis or priapism
into the prepuce. The effects on penile circulation following administration of phenothiazine tranquil-
are rapid and severe. Paraphimosis should be treated lisers. In these cases, preputial oedema is not an
as a veterinary emergency. initial component of the condition, but may occur
over time. In cases of priapism, the penis is noted to
Aetiology/pathophysiology be firm and partially erect, whereas in cases of partial
Paraphimosis may be accompanied by severe pre- or complete penile paralysis, a flaccid penis that can-
putial oedema following trauma. In such cases the not be retracted into the prepuce is observed.
rapid swelling of the prepuce prevents the penis from
retracting following detumescence. Alternatively, Differential diagnosis
paraphimosis may occur secondary to penile paral- Paraphimosis can be differentiated from simple pre-
ysis, which may be associated with pelvic masses putial swelling and prolapse by careful examination
or neurological disease resulting in damage to the of the affected area. A critical evaluation of the his-
pudendal nerves and/or the retractor penis muscle. tory must include previous drug administration.

2.147 2.148

Figs. 2.147, 2.148 (2.147) Same stallion as in 2.145, 24 hours after initiation of therapy, which included
hydrotherapy, emollients, a support sling and anti-inflammatories. (2.148) Same stallion 48 hours after initiation
of therapy showing resolution of the condition.