Ch.43 Male Reproductive Disorders Flashcards
If a stallions penis is injured while erect, it may swell rapidly and massively from vascular rupture and hemorrhage. Hemorrhage usually originates from where?
superfiicial penile vessels in the plexus external to the tunic albuginea
testicular anatomy
stallion penis anatomy
stallion penis anatomy
stallion accessory sex glands
The penis of bulls is susceptible to injury during mating due to
vigorous thrust that accompanies copulation
Bulls: during copulatory thrusting in which the penis is bent, what occurs?
The tunica albuginea ruptures on the dorsal surfeace of the penis opposite teh attachment of the retractor penis mm
consequence of bulls with penile hematomas
larger hematomas restrict full retraction of the penis and result in prolapse of the prepuce from the sheath
Diagnosis of penile hematoma
presence of a swelling immediately cranial to the scrotum– initially soft, fluctuant and painful, then becomes firm as clot organization and fibrin formation progress
Main ddx for penile hematoma
extensive preputial laceration
others include:
rupture of urethra
abdominal hernia
chronic, fibrous adhesions
What signs are typically not seen with penile hematoma?
-dysuria
-other signs of urethral rupture or blockage, such as extensive preputial cellulitis and water belly, INC BUN/CREA, tissue necrosis
What are possible sequelae to penile hematomas:
abscess formation
fibrous adhesions
venous shunts that communicate between the CCP an other peripenile vasculature or corpus spongiosum penis (CSP)
-failure to find females vagina and/or ejaculate (dorsal nerve of the penis are damaged)
-not able to have full erection
Approximately what percentage of bulls with hematomas that are treated conservatively are reported to return successfully to breeding?
approx 50%
Advantages of surgical correction for penile hematoma:
- removing the blood clot before extensive fibrous adhesions develop
- permitting removal of a blood clot from w/in the body of the CCP itself, therefore reducing the chance of blockage of the cavernous filling
- suturing the tunica albuginea, which should reduce the chance of recurrence of the condition after return to service and likelihood fo developngi vascular shunts tha twill prevent complete filling of the CCP
When should surgical correction of a penile hematoma not the attempted?
-before coagulation of the extravasated blood
-once significant fibrin formation is present, px of successful correction is greatly reduce and should be attempted only in valuable bulls
When should surgical correction of a penile hematoma not the attempted?
-before coagulation of the extravasated blood
-once significant fibrin formation is present, px of successful correction is greatly reduce and should be attempted only in valuable bulls
Recommendations before electing surgical intervention for penile hematoma in bulls
-manually extending penis– extended 6 to 8 inc or more beyond heath orifice and penile sensation remains= good px
-if engorgement of the distal penis does not occur after careful stimulation w/ the electroejaculator, blockage of the CCP should be suspected and reduces the prognosis
-abscesses- poor risk b/c severe restrictive adhesions that usu develop
Conservative tx of penile hematomas
- antimicrobials (prevention of abscess formation)- penicillin best d/t usu T. pyogenes infection
Reasons for phimosis in stallions
stenosis preputial orifice
-sequelae to injury leading to cicatrix formation (rarely congenital
-infectious: eq coital exanthema & dourine
Tumors: melanomas or SCC
Habronema granulomas
Define phimosis
inability to extend the penis into the prepuce
Treatment of phimosis in stallions
-diuretics and exercise (tx edema)
-cryotherapy
-emollient antibiotic preparations and hydrotherapy
-systemic antibiotics
NSAIDS
-sexual rest
-sx removal of cicatrix scars (sometimes successful)
-habronemiasis: systemic insecticides or ivermectin– kill larvae
What gene is linked to weak or failed development of the preputial mm, leading to habitual preputial eversion, which predisposes to injury in bulls?
Polled gene
Causes of phimosis in bulls
trauma to prepuce
congenital anomalies: such as short penis, short retractor mm
developmental anomalies: pseudohermaphrodites
Phimosis is rare in small ruminants, but may be due to:
-congenital -acquires- d/t adhesions or preputial scarring with trauma or balanoposthitis
–acquired phimosis in sm ruminants may be d/t: ulcerative prosthitis d/t Corynebacterium renale, C. pilorum or, C. cystitidis
define paraphimosis
inability to retract the penis into the prepuce
define priapism:
persistent erection
Penile paralysis in stallions likelyd evelops sceondary to:
insuffieicent tone of the trator penis mm
Motor innervation of the retractor penis mm is supplied by
alpha adrenergic fibers
**alpha adrenergic blocking drugs, such as phenothiazine derivative tranquilizers are admin– paralysis of mm can cause penile prolapse
Development of priapism:
-engorgement of CCP with blood and although the horse may not achieve full erection, penis is not flaccid
-penis fails to detumesce, CO2 tension in the CCP increases resulting in INC blood viscosity& subsequent venous occlusion where collecting veins joint the cavernous spaces
-edematous swelling fails of corporal trabeculae further dec venous outflow, thus INC the likelihood of irreversible venous occlusion, fibrosis and arterial occlusion
Causes of penile paralysis
-exhausted or debilitated horses
-myelitis
-spinal injury
-severe injury to penis
What is prognosis for stallion paraphimosis
px for recovery- guarded to grave as chronicity of the problem increases
Treatment of paraphimosis
-retaining the penis within the prepuce: purse string or pro-bang or bottle technique
-injecting bezotropine mesylate (drug induced)
phenylephrine into CCP
-flush CCP with heparinized LRS with 12 gauge needs to remove sludged blood (priapism of 12 to 24 hours duration)
-amputation if blood clot present, px is poor
Causes of paraphimosis in bulls
-same as phimosis
plus: penile tumors, parasitic invasion, traumatic or spinal dz, inadvertently severe retractor penis mm, physical trapping d/t constricted prepuce after injury
-spinal injury
-rabies
C/S of uroliths in stallions
-dribbling of urine with chronic cystitis
-dysuria and stranguria
-occasional hematuria
-recurrent colic
-stilted, painful gait in hind quarters
Define balanitis
inflammation of the glans penis
Define posthitis
inflammation of prepuce
define balanoposthitis
inflammation of prepuce and glans penis
Causes of balanoposhtitis
dourine
equine herpesvirus 3 (EHV-3)
miscellaneous bacteria
parasites
Causative organism of equine coital exanthema
EHV-3
How do stallions become infected with EHV-3
Inapparently infected mare transmits the virus to a stallion at time of breeding
**vice versa
Stallion C/S of Equine coital exanthema
systemic manifestations: dullness, anorexia and fever
-vesicles: up to 1.5 cm, penis then prepuce
-pustules, with raised borders– slough and ulcerate
-refuse to breed mares (when leasons are present)
–healed lesions– depigmented spots
Diagnosis of equine coital exanthema in stallions
-characteristic C/S
-PCR of of swabs or scrapings from edge of lesions, inclusions in lesion specimens or confirmed by using EM typical herpesvirus particles in fluid or tissue samples
Treatment of EHV-3 in stallions
infection is usu self-limiting
If concerned for bacterial infection affecting fertility of stallions, where should swabs be collected from?
-fossa glandis
-free portion of the penile body
-folds of external prepuce
**before washing the genitalia of stallion presented to a mare in behavioral estrus
Treatment of stallion infected with Pseudomonas aeruginosa and Klebsiella pneumoniae
-washing penis (including fossa glandis & diverticulum) daily with iodine based surgical scrub
- rinse with tape water with dilute disinfectants
-drying of penis followed by application of 1% SSD
**concern with reinfection from removing natural flora from the stallions genitals.
transfaunation with healthy stallion smegma may be indicated
Balanoposthitis in bulls is usually associated with traumatic injury and then infection. What infectious agents have been reported to cause Balanoposthitis without trauma?
-bovine rhinotracehitis-infectious pustular vulvovaginitis (IBR-IPV) caused by bovine herpesvirus 1 (BHV-1)
-tuberculosisi
-screwworm infestation
Bulls: acute lesions caused by BHV-1
-numerous small pustules that progress to ulcers and erosion
-purulent preputial discharge
-prepuce and penis inflamed and swollen
Bulls treatment with BHV-1 ccaused balanoposthitis?
spontaneously heal in 1 week and usu complete in 2 weeks
How long should bulls with balanoposthitis be sexually rested?
for 6 to 8 weeks to prevent spread and avoid abrasions
**can be spread venerally for 2 weeks or longer
Bulls infected with BHV-1 remained infected for life, as the virus remains latent in what location?
in the sacral ganglia
Viral shedding of BHV-1 in semen is intermittent, if valuable bulls need to be used, what should be performed?
detection of BHV-1 in semen by real-time PCR is more sensitive than virus culture isolation, two straw of extended processes ejaculate are necessary to detect the presence of the virus
In sheep, important to differentiate pizzle rot from
ulcerative dermatosis (caused by parapozivurs)
What is a cause of balanoposthitis in males and vulvovaginitis in female goats?
caprine herpesvirus
**can also cause abortion
Penile deviations can occur in stallions due to what pathogenesis?
D/t semen collection through most of their breeding carrier– most commonly (in US) to the right d/t repeat bending of the penis to the left to facilitate entry into the artificial vagina which causes damage tot eh CCP/tunic albuginea on right side, resulting in filling defects and fibrotic lesions that lead to penile deviation
define phallocampsis
deviation of the erect penis
phallocampsis is common in what spp
bulls
what is the most common cause of phallocampsis in bulls?
due to persistent penile frenulum
other causes: spiral, ventral and S -curved deviations
Less common; preputial or penile injury
Describe the appearance of a persistent penile frenulum in the bull during erection?
-remains connected to ventral surface of tip of penis & prepuce an causes the penis to bend ventrally during erection by prevention complete extension
Persistent frenulum interferes with copulatory ability with the exception of
Zebu-influenced breeds that are endowed wiht a plentiful prepuce
Spiral deviations can occur without a penile deviation can be caused by what?
electrojaculator when the CCP is maximall distended with blood
Bull: the ventral or rainbow deviation of the penis is less common than the spiral deviation and is a result of
the apical ligament being too thin to support the engorged, stretched distal end of the erect penis
Persistent penile frenulum treatment
severing the persistent band– owners should be advised of the probable genetic basic and therefore undesirability of retaining these bulls for breeding
What is the most common neoplasm of the stallion genitalia
squamous cell carcinoma (SCC)
Squamous cell carcinomas in stallions may resemble what other lesion
-Habronema granulomas
What are other possible tumors seen in the stallion besides SCC?
melanoma
papilloma
angioma
lymphosarcoma
sarcoid
What is the only tumor that frequently invades the bovine penis or prepuce?
fibropapilloma
fibropapillomas are common seen in what age bull?
young bulls
appearance of fibropapillomas on bulls penis
-pedunculated and attached at a narrow base
-cauliflower like and friable
-hemorrhage is easily induced
**large ones may prevent retraction of penis
Treatment of fibropapillomas in bulls
**usually regress spontaneously within a few months
-several vaccines– includign autogenous preparations
-surgical removal indicated– fibropapillomas may recur
What is recommended to reduce the incidence of fibropapillomas in bulls?
housing of young replacement bulls in individual pens (if possible)- to reduce the incidence of penile fibropapillomas
What parasite commonly invades the urethral process, glans penis and preputial ring of stallions?
Habronema muscae
Habronema microstoma
Drashia megastoma
Summer sore appearance in stallions
-shallow irritations
-progress to irregular 1 to 3 cm granulomatous growth– involve the entire circumference of the urethral process
lesions are friable and bleed when manipulated
-intense pruritus
-freq micturition and dysuria
Summer sore diagnosis
seeing yellowish granules (calcified larvae in teh lesion
**microscopially
Hemospermia definition
blood in semen
Does blood in sperm affect fertility in stallions?
Depends on the percentage of blood in extended semen
What does a disproportionate number of luekocytes to erythrocytes suggest in semen
infection of the internal genital organs
What are specific causes of hemospermia in stallions?
lacerations of penis
cutaneous habronemiasis
urethritis
urethral lacerations
infection or inflammation of the accessory genital glands
Define urospermia
urination during ejaculation
Urospermia is a condition in what spp?
stallions
Underlying cause of urospermia?
Unknown– suspect neurologic dysfunction
can occur in bulls during electroejaculation
adhesions develop in the scrotum between the visceral and parietal tunic when
inflammation, infection or hemorrhage occurs
What is a hydrocele
accumulation of serous fluid w/in the vaingal tunic
Causes of hydrocele
ascites
anasarca
local lymphadema b/c vaginal tunic communicates with the peritoneal cavity
what is a hematocele
trauma to the scrotum results in accumulation of blood within the testicular tunics
After hematocele or hydrocele recovery, how long does it take for the spermatozoa to gradually reappare in teh ejaculate?
around 1 to 2 months after injury
**4 to 5 months may be required for testis to return to normal size and sperm production
What is the prognosis for hematocele?
px is poor for return to testicular function
How to correct Hydrocele?
correct underlying pathology, such as the peritonitis or ascites
Define testicular aplasia
absence (aplasia) of one or both testes (rare)
Causes of testicular hypolasia
transplacental infections and intoxications
zinc deficiency
hormonal insufficiency
impaired testicular descent
abnormal karyotype
vascular disturbances
testicular hypoplasia (unilateral or bilateral) is thought to be a result of:
failure of germ cells to multiply in the gonad
Stallions 3 years of age should have a scrotal width greater than
8cm
In bulls what ist he minimum recommended scrotal circumference
30 cm for 15 months old or younger
34 cm for 2 yr olds or older
Scrotal circumference in bulls is associated with
positively correlated with number of normal functional seminiferous tubules
negatively correlated with pathologic seminiferous tubules in bulls
-higher scrotal circumference produce females that acquire puberty earlier than females produced by bulls with smaller scrotal circumference
What is the inheritance pattern of cryptorchidism in horses?
dominant
**may be multifactorial
The relative risk of cryptorchidism in horses is though to be influenced by what factor?
breed
Embryonic development of testes
-testes originate near kidney
-migrate through the inguinal rings before descending into the scrotum
-epididymis precedes the testis in descent
**retained testes are usually located at some point along the path of migration
Why is spermatogenesis inhibited in the abdominal testis?
because elevated temperature w/in abdomen
Diagnosis of equine cryptorchids
-high basal testosterone (>100 pg/ml)
-respond to hCG admin with sig elevation of circulating testosterone w/in 30 to 60 min if testicular tissue is present
-high plasma estorgens (>400 ng/ml)
-Anti-mullerian hormone (AMH) serum concen useful in horses
Testicular degeneration may be caused by:
-thermal factors after elevation of body temperature by systemic infections
-prolonged inc or dec in ambient temperature
-scrotal insulation from edema, dermatitis, scrotal hernias or hemorrhage
-abnormal conformation resulting in an incompetent heat exchange sys
-chemicals and ionizing radiation
-steroid hormone administration
Hormonal criteria for confirming testicular degeneration in stallions typically include
-low concen of testosterone
-low LH concen (early)
-high FSH & low estradail (chronic (or irreversible))
What is commonly isolated from infectious orchitis in stallions?
S. zooepidemicus
In bulls, infectious orchitis can be caused by:
B. abortus
M. tuberculosis
T. pyogenes
Nocardia farcinica
bovine herpresvirus-1 (IBR-IPV)
other misc organisms
C/S of acute orchitis
testes are hot, swollen and painful
–> swollen d/t restriction of tunica albuginea
–> INC tesicular temp, congestion and interference with circulation may lead to ischemia and infarction
+/- abscess formation
–> testicular atrophy and fibrosis follow as the condition becomes chronic
Treatment of acute orchitis
cryotherapy
antiinflammatories
antibiotics (semen culture/sensitivity)– cont for 1 to 2 weeks after testicular swelling and pain
Where do testicular tumors originate from?
interstitial (Leydig) cells
Sertoli cells
germinal epithelium
testicular surface: teratomas, lipomas, lymphosarcoma
What is the most common testicular tumor in the descended testes of adult stallions?
seminomas
What is the most common testicular tumor in the retained testes of adult stallions?
teratomas
Seminomas diagnosed in stallions, do they require removal?
They are not hormonally active and usually benign
can be malignant and invade inguinal and abdominal tissues
Which tumor cell type exerts an adverse effect on semen quality and fertility?
sertoli cell tumors
Structures present in teratomas arise from all 3 embryonic layers and may include
hair, nervous tissue, salivary glands, adipose tissue, cartilage adn bone
What are predisposing anatomy to a scrotal torsion?
-abnormal elongation of the caudal ligament of the epididymis (scrotal ligament)
-the proper ligament of the testis
-excessively long mesorchium
Torsion of the spermatic cord can cause what C/S?
No pain or abnormality of semen to those involving vascular obstruction and acute colic
**often a transient condition
Diagnosis of spermatic cord torsion is made via
displacement of the tail of the epididymis and scrotal ligament on palpation
Normal: head of epididymis normally located craniodorsal to the testis and the tail lies caudally, where it is attached to the testis by the proper ligament
Severe C/S associated with torsion of the spermatic cord are due to
vascular impairment
–abdominal discomfort, tachycardia, tachypnea, unilat swelling and edema of the scrotum, INC testicular temp, tests painful, soft an dfriable
Treatment of spermatic cord torsion
manual correction: sedated, horse sedated and testis is rotated in direction opposite the torsion
Surgical correction/removal of testis: if hemorrhage or necrosis of the testis is evident
NSAIDs and analgesics to control pain
Define variocele
abnormally distended and tortuous veins fo the paminiform plexus
Varioceles are most common in what spp? and identified by what C/S?
Rams– due to size– may decrease libido and discourage movement
Infertilety due to a variocele is thought to be associated with
d/t disturbance of local thermoregulatory mechanism, causing increased testicular temperature and subsequent disturbance in spermatogenesis
**could affect level of oxygenation and normal interchange of hormones between arteries and veins
Diagnosis of variocele
-palpating the dilated tortuous veins (“bag of worms”) within the spermatic cord
-confirmation via U/S: large echolucent areas in the venous plexus of the spermatic cord, with concurrent distention of ventral vein of testis
Besides decreased libido and spermatogenesis, what is a potentially complication that can occur with a varicocele?
thrombosis
Treatment of varicocele:
-surgical removal/ castation:
- improved semen quality in humans (not been done in large animals)
-indicated when thrombosis occurs
**castration also recommended for rams b/c potential heritability
Define epididymitis
infection or trauma, commonly secondary to orchitis o infection fo the accessory sex glands
Diagnosis of epididymitis
-C/S include:
pain when irregular swelling of the epididymis are palpated
-changes in shape & texture of organ
-adhesions between the epididymis and scrotal tunics
-enlargement of the tail of the epididymis
Class presentation of rams that develop epididymo-orchitis syndrome caused by ACitnobacillus, histophilus and haemophilus
-younger than 1 year of age
-subclinical carriers or acutely ill: pyrexia, depression, pain as evidence by arched back, unilateral or bilat swelling & tenderness fo the scrotal contents
If rams recover from acute epididymo-orchitis syndrome and develop chronicdisease, what clinical signs are seen
-enlarged and firm, irregular epididymis
-palpable adhesions of the epididymis to the testis and vaginal tunics
-atrophic testes
-abscess formation
-draining fistulas to the scrotal surface
Epididymitis treatment
-systemic antibiotics (that reach the epididymis): oxytetracycline, dihydrostreptomycin
-castration- in unilateral cases– INc risk of infection
Prognosis for epididymitis
mod to severe bilateral epididymitis: px for recover is poor
–obstructions and granulomas usu develop–> resulting in steirlity
– testiular atrophy
Seminal vesiculitis (vesicular adenitis) is common in what spp?
bulls
– uncommon in stallions
What organisms are incriminated in Seminal vesiculitis in stallions?
B abortus and P. querginosa
What organisms are incriminated in Seminal vesiculitis in bulls?
Actinobacillus actinoides
Aeromonas hydrophila
T. pyogenes
B. abortus
C. psittaci
C. renale
C. pseudotuberculosis
E. coli
H. somni
M. tuberculosis
Mycobaterium paratubcerulosis
Mycoplasmas,
P. mirabilis
Strep
Stsaph Ureamplasmas and T. goetus
In bulls what is the most frequently isolated in Seminal vesiculitis
T. pyogenes
Seminal vesiculitis/ vesicular adenitis most common signalment (bulls)
-bulls of all ages
-most common: growing bulls fed high energy rations and housed together
Seminal vesiculitis/ vesicular adenitis in bulls C/S
-asymptomatic
-non specific C/S other than detioration of semen quality
Severe cases: pelvic inflamm and peritonitis result in pain, reluctant to move, stiff gait, tense abdomen, difficult defecating and refusal to mate
Can enlargement of the vesicular glands increased with seminal vesiculitis?
-acute phase: vesicular glands may not be significantly increased in size
-chronic phase: glands enlarge, eventually losing their lobularity and becoming fibrotic
Abscessation of the seminal vesicles is often caused by what bacteria ( in bulls)?
T. pyogenes
Consequence of abscessation of theseminal vesicles (in bulls)?
rupture into the urinary bladder or rectum
What are characteristics of semen from bulls with vesicular adenitis?
-poor sperm motility
-increased morphologic defects
-elevated pH
bacterial pathogens can be recovered from semen of affected stallions with vesicular adenitis, does this equate to infection?
No– bacteria could originate from another location
What method shows low contamination of the semen samples collected from bulls?
-clipping of preputial hairs
-urination
-antisepsis of the preputial area
-flushing of the preputial cavity with antiseptic solution
-per rectum massage of accessory sexual glands
-semen collection by electroejaculation
Treatment of seminal veisculitis (vesicular adenitis)
-antibiotics: based on CS, 2-4 wks duration, direct instillation into stallions seminal vesicles
-NSAIDs
-massage of seminal glands per rectum
-sx removal: seminal vesiculectomy
What are properties of antimicrobials suitable for parenteral treatment of accessory sex gland infection include:
-high lipid solubility
-favorable pKa (higher than the pH (basic) of the target tissue or fluid)
-low or ltd protein binding
Prognosis for seminal vesiculitis
-fair to poor
Sperm granulomas are caused by:
accumulation of spermatozoa in blind efferent ducts
**common cause of infertility in buck and ram
**have been IDed in stallions
Block of efferent ducts (sperm stasis), results in what
azospermia despite apparent ejaculation
–ampullae freq tense & enlargement may be demonstrated by U/S
Treatment of blockage of efferent ducts (sperm stasis)
massage of ampullae per rectum followed by freq intervals for semen collection may result in ejaculation of a semen sample with high concen of spermatozoa (strings & plugs)
–collection of semen on a regular schedule may aid in preventing recurrence
–empiric tx of blockage of beta-receptors and stim of alpha receptors
