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LA SX FINAL > Genital Surgery - Male > Flashcards

Genital Surgery - Male Flashcards

1
Q

What is a phallectomy/penectomy?

A

Surgical removal of the penis

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2
Q

What is paraphimosis?

A

Foreskin becomes trapped behind the glans penis, leaving the penis out and unable to return to the sheath

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3
Q

What is phimosis?

A

Foreskin too tight to be pulled bak over the head of the glans penis

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4
Q

What is posthioplasty/reefing?

A

Surgical reconstruction of the prepuce

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5
Q

What is priapism?

A

Persistent abnormal erection

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6
Q

What is a phallopexy?

A

Permanent adhesion between the dorsal preputial mucosa and the dorsal surface of the penile shaft

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7
Q

What aspect of the testicle is the cremaster muscle attached to?

A

Lateral

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8
Q

What aspect of the testicle is the head of the epididymis on?

A

Cranial

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9
Q

What is the out-pouch of the peritoneum that covers the testicle?

A

Vaginal tunic

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10
Q

What is the cremaster muscle attached to?

A

Vaginal tunic

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11
Q

What aspect of the testicle is the body of the epididymis located?

A

Lateral

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12
Q

Castration steps 1-3

A
  1. Wipe scrotal injection sites with alcohol
  2. Inject each testicle with local anesthetic until full (20-50 mL/testicle) and check for CM paralysis
  3. Aseptic preparation of surgical site and surgeon
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13
Q

Castration steps 4-6

A
  1. Make two parallel scrotal incisions 2 cm from median raphe
  2. Incise into cranial portion of vaginal tunic of testicle; place finger in tunic; place Kocher forceps firmly over tunic and tail of epididymis
  3. Apply firm tension of tunic/testicle; use other hand to strip away connective tissue and fat covering tunic and cremaster muscle
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14
Q

Castration steps 7-9

A
  1. Divide cremaster from vaginal tunic; clamp with angiotensin and section with electrosurgery distal to clamp
  2. Expose pedicle from inside tunic; bluntly puncture mesorchium to separate into vascular and non vascular portion
  3. Clamp with angiotribes and ligate vascular portion and section with electrosurgery; not right at clamp - you can go over again
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15
Q

Castration steps 10-11

A
  1. Replace lighted vascular portion inside tunic
  2. Clamp and ligament tunic and section with electrosurgery preventing inside and outside world communication
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16
Q

Castration steps 12-13

A
  1. Repeat 5-11
  2. SQ closure for scrotal incisions and/or invert scrotum and glue
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17
Q

In order to justify closing skin, must have perfect ____. If not, leave open for drainage.

A

Homeostasis

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18
Q

Name the instrument

A

Serra curved handles

19
Q

Name the instrument

A

Kosher/Oschner forceps

20
Q

What are these?

A

Reimer emasculators

21
Q

What are these?

A

Modified white Haussmann/white franks

22
Q

What are these?

A

Ferguson Angiotribe Forceps

23
Q

What should aftercare for a castration look like?

A

24-36 hours of being quiet then exercise 2X/day for 20 minutes for 2 weeks

24
Q

What are three possible castration complications?

A
  1. Hemorrhage
  2. Scirrhous cord - hard, dense cancerous growth usually arising from connective tissue
  3. Eventration vs evisceration
25
Q

What do ponies need prior to castration?

A

Heavy sedation prior to induction of anesthesia with ketamine to avoid muscle rigidity and to ensure adequate duration of anesthesia

26
Q

How do you prevent hemorrhage when castrating?

A

Ligate the cord on mules, donkeys, and mature stallion
Crush cord for 6 minutes prior to removal of emasculator on draft horses
Cross clamp cord for 24 hrs with right angle clamp

27
Q

What should you make sure you do if you ligate during castration

A

Maintain sterility

28
Q

How do you prevent visceral prolapse?

A

Ligate cord in all horses with predisposition to inguinal hernias and/or large vaginal rings and horses with history of inguinal swelling

Horses with predisposition to inguinal hernias: draft horses, some standardbred lines, gaited horses

29
Q

How do you treat visceral prolapse?

A

Anesthetize horse, replace bowel and suture superficial ring and skin

Anesthetize horse, suture skin incision

Pack canal and close skin

Pack canal and wrap groin

REFER

30
Q

What are the classifications of a cryptorchid?

A
  1. Inguinal: testicle and epid are out of the abdomen t but not in the scrotum
  2. Abdominal:
    Partial - testicle in abdomen, epid outside
    Complete - testicle and epid in abdomen
31
Q

What type of cryptorchid can eventually descend?

A

Inguinal
Abdominal cryptorchid will never descend

32
Q

Are R or L cryptorchid more likely?

A

Equal in occurrence

33
Q

Are unilateral or bilateral cryptorchids more likely?

A

Unilateral 9X more likely than bilateral

34
Q

If a horse has the right testicle descended, but not the left, what type of chryptorchid is it most likely to be?

A

75% likely abdominal

35
Q

If a horse has the left testicle descended, but not the right, what type of cryptorchid is it most likely to be?

A

60% likely to be inguinal

36
Q

Are bilateral abdominal or bilateral inguinal cryptorchids more likely to occur?

A

Bilateral abdominal 2.5X more likely

37
Q

What are the surgical approaches for cryptorchids?

A

Inguinal
Parainguinal
Flank
Ventral midline
Laparoscopic (GOLD STANDARD)

38
Q

What are the indications for a partial phallectomy?

A

Intractable paraphimosis
Traumatic penile injury
Squamous cell carcinoma

39
Q

What is the most important aspect of the William’s technique?

A

Hemostasis

40
Q

What do you transect when doing a perineal urethrostomy on a horse?

A

Corpus spongiosum

41
Q

What are the 7 steps of William’s technique?

A
  1. Place catheter in urethra
  2. Remove triangular piece of skin w/base toward end of penis
  3. Make incision into urethra
  4. Directly attach urethral tissue to skin
  5. Transect distal end of penis
  6. Take tunic and close with simple interrupted
  7. Take urethral mucosa saved and attach to end of penis
42
Q

What is the Boltz technique used for?

A

Treatment of paraphimosis

43
Q

What are the steps of the Boltz technique?

A
  1. Manually retract to far end of sheath
  2. Not so far that they urinate in their sheath but so frost bite or trauma are less likely to damage it
44
Q

Why is priapism considered an emergency?

A

Blood can clot
Damage to the penis

LA SX FINAL (8 decks)

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