Page 572 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Reproductive system: 2.2 The male reproductive tr act 547

VetBooks.ir 2.151 2.152

Fig. 2.151 This Thoroughbred racehorse colt has Fig. 2.152 Smegma accumulation, also referred to
sustained severe direct trauma to its prepuce and as a ‘bean’, within the fossa glandis of a gelding that
penis leading to extreme swelling and fresh bleeding presented with difficulty in passing urine.
lacerations of the penis and prepuce. (Photo courtesy
Graham Munroe)

Determination of the involved structures and sever- on the severity of the injury and involvement of the
ity of injury can then be made. If an injury is not corpus cavernosum or urethra. Significant fibrosis
immediately apparent, careful attention should be can occur following haematoma formation, which
paid to the urethral opening, as small lacerations may result in penile deviations, incomplete erec-
may be easily missed. tions, ejaculatory dysfunction and penile paralysis.

Management SMEGMA ACCUMULATION
Penile injuries are emergencies and early treatment
is essential for success. Treatment options should Definition/overview
be aimed at replacing the penis into the prepuce as Smegma is the foul-smelling accumulation of secre-
soon as possible in order to avoid secondary compli- tions of the sebaceous and sweat glands of the pre-
cations such as paraphimosis. Simple lacerations of puce. It forms on the penis and, particularly, within
the penile skin heal well without suturing if swelling the fossa glandis.
and local infection are controlled. Strict sexual rest
is necessary until healing is complete. Deeper lac- Aetiology/pathophysiology
erations will require general anaesthesia and surgical Excessive accumulation of smegma may result in
debridement and suturing. Careful evaluation of the irritation and mild balanoposthitis. Significant
extent of the injury is necessary, as deep lacerations quantities of the thick, wax-like material may form a
may involve the corpus cavernosum and the urethra. ‘bean’ within the fossa glandis and result in discom-
Supportive care includes systemic broad-spectrum fort and difficulty during urination or even ejacula-
antibiotics and anti-inflammatory therapy. A signifi- tion (Fig. 2.152).
cant potential for paraphimosis and/or penile paraly-
sis (see above) exists. Clinical presentation
A foul-smelling odour may be noticed from the
Prognosis stallion’s or gelding’s sheath or he may experience
Simple injuries will heal uneventfully with prompt excessive straining during urination. In most stal-
treatment. In more severe cases, recovery is dependent lions used for regular breeding or semen collection,