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EXAM 3 FINAL > Male Repro Surgery > Flashcards

Male Repro Surgery Flashcards

1
Q

What are some common surgical procedures of the TESTIS?

A

Castration
Vasectomy/Epididectomy
Cryptorchidism

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2
Q

What are some common surgical procedures of the PREPUCE?

A
  • Penile/Preputial stricture
  • Preputial erosion
  • Preputial prolapse
  • Preputial avulsion
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3
Q

What are some common surgical procedures of the PENIS?

A
  • Penile hematoma
  • Persistent frenulum
  • Tumor removal
  • Penile deviation
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4
Q

How are the Testes Oriented?

A

Vertically with prominent tail of epididymis

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5
Q

Where is the Epididymis and ductus deferents located in relation to the TESTES?

A

Along the caudo-medial surface of the testicle

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6
Q

What are the layers of the TUNICA VAGINALIS?

A
  • visceral layer

- parietal layer

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7
Q

What two muscles are very important in thermoregulation of the testicles? HOW

A
  • cremaster muscle
  • Dartus muscle

Elevate and drop the testes in relation to the body.

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8
Q

What does the spermatic chord comprise of?

A
  • nerves
  • vessels
  • lymphatics
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9
Q

What is the importance of properly lighting the Testicular ARTERY during castration?

A

Testicular artery is a branch of the abdominal aorta:

-life threatening hemorrage

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10
Q

In the Bull, what temperature is the testis in relation to the body?

A

Should be 4 degrees lower

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11
Q

The highest concentration of testosterone is in the _______?

A

Testes
-exchange of testosterone coming out of the testicle
-diffuses into the testicular artery, that takes it back to the testicle
——affecting testosterone and thermoregulation

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12
Q

What does the Pampiniform plexus contain?

A
  • TORTUOUS artery

- Contorted vein

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13
Q

How old should calves, lambs and kids be when they are castrated?

A

1st month of life

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14
Q

Can you castrate animals older than 1 month of age?

A

YES, but not ideal:

  • More prone to complications
  • Difficult restraint
  • Less effective in behavior control
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15
Q

How do you restrain a Lamb/Kid for orchidectomy?

A
  • Head down between operators knees

- Head up with limbs on each side held together

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16
Q

How would you restrain a Calve (<30days, ideal age) for orchidectomy?

A

Lateral recumbency

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17
Q

How would you restrain older cattle/sheep/goats for orchidectomy?

A
  • stocks
  • chutes
  • tilting table
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18
Q

T/F: there is proof that castrating an animal later will produce better meat

A

FALSE

No proof, common thought

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19
Q

T/F: there is proof that castrating an animal younger (within the first month) is easier, more effective and less associated with complications

A

TRUE

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20
Q

What is one of the most common mistakes for mix animal practitioner when castrating?

A

Mixing the xylazine used for Horses with the xylazine used for cattle

-Ruminants are MORE sensitive to Xylazine than horses

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21
Q

What dosage of Xylazine is used in:

  • Horses
  • Cattle
A

Horses:
100mg/ml

Cattle:
20mg/ml

Small Ruminants are even More sensitive

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22
Q

What would you expect to see in a Cow that received too much Xylazine?

A

Cardio vascular and Respiratory compromise

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23
Q

What is the toxic dose of lidocaine for Ruminants ?

A

4-6mg/kg

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24
Q

T/F: the dose of Xylazine used to sedate CATTLE is more or less 10% of the dose used in HORSES

A

TRUE

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25
Q

Which species is most sensitive to lidocaine toxicity?

A

GOATs stay below 4-6mg/kg

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26
Q

Why do we use intra-testicular administration of lidocaine instead of injection into the chord?

A

Due to possible hematoma development

-if that happens in the chord then hemostasis would be compromised

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27
Q

How much should you dilute your lidocaine for intra-testicular administration in a GOAT?

A

0.5-1% of toxic dose 5mg/kg

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28
Q

What are the 2 ways to castrate a Ruminants?

A

1) Scrotal apporach

2) blood less method

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29
Q

Describe the scrotal approach to castration

A
  • excise the distal 1/3 of scrotum
  • isolate spermatic cord
  • ligate and transects/emasculation/Henderson castrating tool
  • Push chord stump back into the inguinal canal
  • SECOND intention HEALing
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30
Q

How do you use a Newberry knife?

A
  • vertical incision in lateral aspect of scrotum
  • placed midway cranial to caudal (below levels of testes)
  • Rapidly pull distally —> cranial/caudal scrotal flaps
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31
Q

What is the most common castration technique in Ruminants?

A

Closed technique

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32
Q

What is the Henderson Castrating tool?

A

Twists spermatic chord until it breaks

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33
Q

What are the two most common emasculators used in Ruminants?

A

1) Reiner

2) Serra

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34
Q

What is extremely important to check when using a Serra emasculator and why?

A

Check that it is NUT to NUT because the Serra crushes and cuts at the same time

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35
Q

Why do you digitally stretch the scrotal incision following scrotal castration?

A

To enhance drainage

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36
Q

What is one of the most important complications of castration?

A

Serous chord formation

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37
Q

Why / When would you perform a unilateral castration?

A
  • Hydrocele
  • Hematocele
  • testicular tumor
  • Abcess
  • varicocele
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38
Q

How long would you have to wait after performing a unilateral orchidectomy to see if the remaining testicle is functional?

A

up to 2 months (60day) post-op

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39
Q

T/F: unilateral orchidectomy can cause compensatory hypertrophy and increase sperm production in the remaining testicle.

A

TRUE

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40
Q

What type of castration technique should be used for unilateral orchidectomy?

A

OPEN castration technique

  • vertical skin incision through parietal vaginal tunic
  • involves closure of tunic,SC and Skin with absorbable suture
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41
Q

What is the ratio for fusiform incisions?

A

4: 1
3: 1

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42
Q

What is the Bloodless castration?

A

Dependent on ischemia of testis—->atrophy/necrosis

  • elastrator
  • callicrate bander
  • burdizzo emasculotome
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43
Q

T/F: the prevalence of tetanus following bloodless castration is much higher than the other approaches

A

TRUE

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44
Q

Can an Elastrator bander be used on an adult ruminant?

A

No must be <1 month of age

-testes and scrotum slough in ~3 weeks

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45
Q

Where should the Elastrator bander be placed?

A

Right at the neck of the scrotum

  • remove wool/hair first
  • monitor these animals
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46
Q

What age group and animals can Callicrate banders be used in ?

A

Also known as EZ bander

  • bulls up to 400kg
  • Adult small Ruminants
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47
Q

How does the Burdizzo emasculotome work?

A

Bloodless castration

  • crushes the spermatic chord
  • crush one chord at a time
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48
Q

Is cryptorchidism common in ruminants?

A

No (less common than in other species)

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49
Q

What is the most common location of cryptorchidism in ruminants?

A

ECTOPIC > inguinal> abdominal

50
Q

Which is more common in Cattle bilateral orchidectomy or unilateral orchidectomy?

A

Unilateral

Retain:
Cattle Left > right
Goats Right > left

51
Q

How do you diagnose cryptorchidism in ruminants?

A

-inspection/palpation of inguinal area and scrotum
-US of SQ inguinal First!!!!
(Then inguinal and abdominal areas)
-TR palpation

52
Q

Where would you find ECTOPIC cryptorchidism in ruminant?

A

In SQ in the inguinal area

  • on either side of penis
  • 15-30cm from base of scrotum (palpation/US)
  • oriented with long axis parallel to penis
53
Q

What type of healing should be done for Ectopic cryptorchidectomy?

A

2nd intention

54
Q

How long does it take for Epididymectomy/vasectomy to cause infertility?

A

3~ weeks post op

  • to create TEASERS
  • allows mating —> no prevention of VDs

*better combine with prepuce relocation

55
Q

What is Epididymectomy?

A

Removes the tail of the epididymis

-to produce teasers

56
Q

Describe the Vasectomy approach

A

1) 1-2 cm vertical incision in neck of scrotum (cranial)
- Continued through vaginal tunic
- 1 incision per side

2) Prolapse spermatic cod through incision
- with curved hemostats
- identify ductus deferents (RIGID and WHITER)
- ligation + transaction

3) skin closure

57
Q

Why is it better to combine vasectomy and epididymectomy with prepuce relocation?

A

It will prevent mating and the transmission of venereal disease

58
Q

What does the PUDENDAL Nerve block do?

A

Relaxation and desensitization of Penis and Prepuce

*for STANDING surgical procedures!!!

59
Q

Describe the components of the PREPUCE

A

1) Lamina externa
- skin
- reflected at the Preputial orifice

2) Lamina interna
- lining of Preputial cavity
- attached to penis (10cm from tip)
- elastic —> lie along body of penis when exteriorized

60
Q

What does Penile/Prepuce relocation do?

A

1) prevents INTROmission (teaser production)

- improved heat detection (better timed AI)

61
Q

When can Penile/Prepuce relocation be performed?

A

FROM 1 month of age
- increased complication in large bulls

  • some learn to achieve intromission despite relocation
  • therefore it is GOOD to combined with Vasectomy/Epididymectomy
62
Q

Where do we normally relocated the Prepuce to?

A

Normally the LEFT flank

-can be done on the RIGHT flank

63
Q

How is a Penile/Preputial relocation performed?

A

1) circumferential incision 2-4cm around orifice

2) extend caudally along midline until 5 cm from scrotum

64
Q

What Nerve block should be performed to Relax (exteriorize) and desensitize the PENIS for STANDING procedures?

A

PUDENDAL NERVE block

65
Q

What is Prepuce avulsion?

A

Avulsion of the Lamina INTERNA from penile integumentary

66
Q

What is the most common cause of Prepuce avulsion in Cattle?

A

-Exclusive of bulls collected with artificial vagina

67
Q

What type of healing should be done for Prepuce avulsion?

A

1) 2nd intention
- time consuming (6-12months)
- adhesion formation

2)surgical repair

68
Q

What is the best treatment for Prepuce avulsion and why?

A

Surgical repair
- because second intention healing can take up to 6-12months and causes a lot of adhesions (preventing the bull from mating again)

69
Q

How would you diagnose a Preputial avulsion?

A

1) Preputial bleeding after semen collection

2) Extension and evaluation of penis

70
Q

What is the typical presentation of a Preputial avulsion in cattle?

A

1) Preputial bleeding following semen collection

2) 2-5cm lesion circumferentially

71
Q

What does surgical repair of a prepuce avulsion require?

A

1) suture closure (with simple interrupted, absorbable)
2) Avoid sexual stimulation (~30days)
3) re-assess

72
Q

Which breed of cattle are more prone to Preputial injuries and WHY?

A

Bos Indicus

  • because they have pendulous sheaths
  • Preputial eversion
73
Q

Where do Preputial abscesses usually occur?

A

Midway between the Preputial orifice and the scrotum

74
Q

How do you treat Preputial injuries? How is this different from Prepuce avulsion?

A

1) try to decrease swelling
2) replace Preputial Lamina back into the Preputial cavity
3) wait 6-8weeks (let tissue declare itself)
* Prepuce avulsion should be surgically corrected immediately (primary intention)

75
Q

What is Preputial prolapse?

A

Eversion of Lamina interna

76
Q

What breeds of cattle is Preputial prolapse common in and why?

A

**Bos Indicus (pendulum prepuce)

*Polled breeds (vestigial caudal Preputial muscle)

77
Q

What first aid can be used for Preputial prolapse?

A
  • soak in salt water/hyperosmotic solution (softens scabs debris = decrease swelling)
  • Massage prolapsed prepuce with LANOLIN, oil and antibiotics
  • Replace prolapsed prepuce and support for 2 weeks
78
Q

A Bos Indicus has a Preputial prolapse that remains prolapsed after 2 weeks following first aid treatment. What surgery should be performed?

A

Surgery only after swelling has resolved

Procedures:

  • longitudinal incision
  • Preputial amputation
  • reefing
  • Preputial stoma
79
Q

What surgical procedure would you use for a simple Preputial stricture? (Prepuce prolapse)

A
  • longitudinal incision of stricture @ Lamina interna
  • transverse closure with interrupted sutures
  • this increases the Lumen of the ring
80
Q

You have a Bos Indicus with a lot of damage to the Lamina interna of the prepuce. What kind of surgical repair would you consider?

A

1) Preputial amputation

2) Reefing

81
Q

Describe Preputial amputation

A
  • Pudendal nerve block
  • plastic case into Preputial cavity (60ml syringe case) for SUPPORT
  • stabilize prepuce (2 long needles at right angles through healthy prepuce)
  • Diagonal incision to excise stenotic prepuce
  • suture edges of healthy portion of prepuce together (interrupted suture pattern)
  • Tube + tape retention device (2 weeks)
82
Q

Describe Reefing

A

*for large stricture in prepuce

-marks in both edges of healthy prepuce for alignment
-tourniquet
-circumferential incisions prox and distal to tissue to be excised
-connect with longitudinal incisions
-dissect tissue for removal
-suture remaining edges together (SI, absorbable)
SQ layer and Preputial integumentary
-SUPPORT

83
Q

What is STOMA technique?

A

Novel technique, for semen collection
-Bulls with Phimosis due to stenosis

1) longitudinal elliptical incision on ventral aspect
- proximal to stenotic scar
- ~6cm long and 2 cm wide
- skin excised
- Incision through Lamina interna@ distal end of incision
- edges of incised Lamina interna are sutured to skin @ stoma

84
Q

What causes Decubital ulcers in Rams?

A

Usually only show Rams

  • Overweight
  • confined, long recumbency
85
Q

How would you treat a show Ram with a Preputial erosion/ulcer (decubital ulcer)

A

Requires surgical excision

-must resist conservative treatment (will not get better)

86
Q

What is the etiology of Preputial erosions/ulcers in Cattle?

A

Hair clipped too short—> urine scolding (Preputial orifice)—>ulceration—>secondary infection—>stricture

87
Q

How do you treat Preputial erosion/ulcers in cattle?

A

Same as Preputial injuries

-surgery

88
Q

Where do the retractor penile Muscles attach in the penis?

A

Centrally at the DISTAL loop of the Sigmoid flexure

89
Q

What are the important components of the Penis in the bull?

A

1) Sigmoid flexure
2) retractor penile Mscles
3) Mucosa diverticula
4) Corpus cavernosum
5) Apical ligament

90
Q

Where is the Mucosa diverticulum located?

A

@ the is hail arch

-important for catheterization

91
Q

What is the Corpus Cavernosum encased by?

A

Thick, INELASTIC tunica albuginea

92
Q

Where is the Apical ligament?

A

Dorsal, Thick

93
Q

What allows the bull to maintain a straight penis during INTROmission?

A

Apical ligament

-dorsal and think

94
Q

What provides sensory information to the penis?

A

Dorsal Nerve of the Penis (branch of Pudendal)

  • key role in penetration
  • unable to serve and ejaculate if damaged
95
Q

T/F: the Pudendal Nerve has sensory and motor function

A

True

  • motor (retractor penis muscle)
  • sensory (Dorsal nerve of Penis)
96
Q

Why is there a decreased risk of damage to the dorsal never of the penis in the free end of the penis?

A

There is distal branching

97
Q

When would you anesthetize the Dorsal nerve of the Penis?

A

-analgesia of free part of the penis
(Minor Sx procedures (Frenula, Papilloma)

-Only in bulls <1 year old
(You can with draw penis from prepuce manually)

-

98
Q

How do you anesthetize the Dorsal Nerve of the Penis?

A
  • Lidocaine injected beneath Lamina interna of prepuce
  • @ dorsal aspect of Preputial orifice
  • Cover dorsal 1/2 of penis
99
Q

What does examination of the penis involve?

A

1) inspection/palpation, prepuce distention

2)Extend penis
—manually (<1 year old bulls)
—sedation (xylazine, acepromazine
—Pudendal nerve block

3) view mating attempt!!!!!*
4) radiograph/ultrasound

100
Q

What is the MOST common PENILE lesion in Bulls?

A

Penile Hematoma
-more common in young)
-due to bending of erected penis (rupture albuginea)
-in dorsal or lateral aspect of penis distal to distal curve of Sigmoid flexure
(Ventral attachement of retractor penis MSc)

101
Q

Where do Penile Hematomas usually occur in the bull?

A

-Dorsal or lateral aspect of Penis distal to distal curve of “S”

(Ventral attachement of retractor penis muscle)

102
Q

What are the clinical signs of Penile hematoma?

A

1) protrusion of Lamina interna (incomplete withdraw)

2) Paraphimosis

103
Q

Why do you see paraphimosis with Penile Hematoma?

A

Due to the space occupying capacity of the hematoma

104
Q

When is surgery required for a Penile Hematoma?

A

-Swelling >15cm

Should be performed within 10 days

  • remove blood clots
  • close albuginea defect its absorbable suture
  • partial thickness to avoid leaking (erection)
105
Q

When is surgery not required for a Penile Hematoma?

-how would you treat it?

A

Swelling <15cm

  • 6weeks sexual rest
  • hydrotherapy (cold/warm)
  • Massage to reduce adhesions within prepuce
106
Q

If you have a valuable bull with a penile hematoma what is the best treatment for it?

A

Surgery

-better recovery

107
Q

What are the complications of Penile hematoma?

A

1) Adhesions **
—most likely in hematomas > 15cm

2) abscesses
3) Recurrence is common

108
Q

What is a persistent frenulum?

A

Congenital condition
-Lamina interna of prepuce continuous with integumentary of penis

  • separarteion completed at 9months
  • more common in ventral aspect of penile rap he (last to separate)
  • Bulls or rams may retain 1 or more bands
109
Q

At what age should the Lamina interna of prepuce separate from the integument of the penis?

A

9months of age

-bulls

110
Q

How do you treat a persistent frenulum?

A

Preputial separation

-anesthetize the DORSAL n of the penis

111
Q

What is the most common neoplasia in BULLS?

A

Penile Fibropapilloma

112
Q

What age group do we commonly see Penile fibropapilloma in? What is the significance?

A

Commonly affects young bulls

*if seen in older bulls ALWAYS submit for biopsy because it could be fribroSARCOMA that looks similar

113
Q

T/F: penile Fibropapilloma is SElf-limiting.

A

TRUE
-often spontaneous regression

Affects mostly young bulls

  • large number in group-housed cattle
  • wart vaccine decreases incidence
114
Q

What can you use to decrease the incidence of Penile fibropapilloma?

A

Wart vaccine!!!!

115
Q

What is the pathogenesis of Penile fibropapilloma?

A

1) affects INTROmission
—pain
—mechanical

2)Affects SEMEN quality
—bleeding

116
Q

Penile fibropapilloma can be treated with benign neglect, So why might you choose to have surgery instead?

A

To save TIME

117
Q

What nerve needs to be anesthetize for Penile fibropapilloma surgery?

A

DORSAL penile N

-sharp dissection/electrobistury

118
Q

When is spiral penis normal in bulls?

A

Spiral is normally @ ejaculation ONLY!!!!!!!

119
Q

What is the cause of Premature spiral formation?

A
  • slippage of APICAL ligament prior to intromission

- prevents intromission in 50-100% of attempts

120
Q

What does Spiral deviation prevent?

A

INTROMISSION

121
Q

How do you treat Spiral deviation?

A

1) anchoring the apical ligament to the penis
—to avoid lateral slippage

2)Implant to augment the apical ligament (DORSALLY)
—strip/s of fascia late
—synthetic fibers

*preferable under GA

Renders bulls useful again

EXAM 3 FINAL (19 decks)

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