Castration Flashcards
Castration can treat/prevent what disease?
Crytorchidism
Neoplasia (testicular/scrotal/perianal gland adenoma)
Testicular torsion
Testicular abscesses
Scrotal urethrotomy
Prostatic diseases -cyst, abscess, BPH (doesn’t treat prostatic cancer)
Perineal hernia (testosterone weakness pelvic muscles)
Most common surgical approach for castrations?
Pre-scrotal (dogs)
When is a scrotal approach used?
Scrotum is incised but not removed
Pre-pubertal puppies
Cats
When would you use a perineal approach to a castrations?
Done to avoid resposition patient
More difficult to displace testicles
When would you do a scrotal approach with ablation for castration?
Testicular or scrotal neoplasia/ trauma
Testicular torsion
Scrotal urethrostomy
Large mature pendulous scrotum
When would you do an inguinal or abdominal approach for castration?
Cryptorchid
If inguinal, incision made directly over testicle
If abdominal , usually a audial ventral midline abdominal approach.. follow vas deferens/testicular artery
Is the prescrotal approach, how is the patient draped?
2-3ccm off midline
Scrotum is out of surgical field
Where do you make your incision in a prescrotal approach?
You will advance the testicle and then make your incision on the median raphe over the testicle
Should you do an open or closed castration in a dog with a large pendulous scrotum?
Closed
What is the difference between a closed and and open castration
Closed — does not penetrate PVT
Open — penetrates PVT
PVT= parietal vascular tunic
Benefits of closed castration?
Decreased risk of scrotal hematoma
Decreased postoperative swelling
Benefits of open castration?
Decreased risk of ligature slipping
Decreased risk of abdominal hemorrhage
How do you do a closed castration?
Ventral traction on testicle through incision
Strip spermatic fascia and scrotal ligament
Exteriorize spermatic cord
3 clamp technique (Rochester -carmalts) - proximal is placed 1-2cm from body wall, next two are 5mm apart
What suture do you use to ligate ?
2/0 monofilament absorbable (PDS)
Millers in crush of proximal clamp and transfixing/millers/circumferential proximal to remaining clamp
How do you close your incision after a castrations?
Two layer closure
3/0 monofilament PDS
-deep tissue and SQ — take bit of superficial midline, avoid urethra, bury knots
Skin
How do you do an open castration.?
Provide ventral tension to exteriorize testicle
Do NOT strip spermatic fascial
Incise into PVT (NOT into VVT)
Exteriorize testicle
Place hemostat across PVT attachment
Digitally break down
Separate vessel from ductus deferens
3 clap ligation (ligate ductus and vessels together, ligate PVT separately
Common complications from castration?
Scrotal hematoma
- cold and warm compress
Infection
- poor aseptic technique
- collar
- antibiotics and topical cleansing
Hemorrhage
- inadequate ligation
- intra-abdominal hemorrhage
Swelling/bruising (very common)
What do you call absence of both testicles?
Anorchism
What do you call absense of a single testicle?
Monarchism
What do you call one or both testicles not descended into scrotum?
Cryptorchidsim
Most testicles descend in 30-40days
If not descended by 6months =cryptorchid
Signalment of cryptorchids?
Dog and cats
Unilateral more common
Small breeds — chihuauaha, poodle, Pomeranian
T/F: crytorchid testicles are sterile and predisposed to neoplasia and torsion
True
T/F: you should always look for other abnormalities in cats and dogs
True
Canine
- hip dysplasia
- patellar luxation
- penile/preputial luxation
- umbilical hernia
Feline
- patellar luxation
- short or kinked tail
- tarsal deformities
- eyelid angenesis
3 locations of crytorchid testicles and treatment of these?
Prescrotal — remove normal testicle first and the push crytorchid testicle into same incision
Inguinal - incision over testicle and open castration
Abdominal — confirm by U/S, caudal abdominal approach
Move back to ventral midline
Follow testicular artery or vas deferens
How do castrations of feline patients?
Pluck, do not clip scrotum
Dorsal or lateral recumbency
Legs pulled cranial
Incise cranial to caudal over testicles
Exteriorize
Closed
- liagate cord with overhand or figure 8 knot, allow to heal by second ingestion
OR
Open castration
-incise PVT then same ligature technique as dog or tie ductus deferens
Allow to heal by second intension
Complications of feline castrations?
Funiculitis
Scrotal hematoma
Scrotal abscess
Priapism
