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Small animal surgery I > Male reproductive tract > Flashcards

Male reproductive tract Flashcards

1
Q

What is the definition of cryptorchidism?

A
  • Failure of either testicle to descend
    • Monorchidism–absence of one testicle
    • Anorchidism–absence of both testicles
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2
Q

What are the characteristics of cryptorchid testicles?

A
  • Sterile
  • Suppress spermatogenesis in normal testicle
  • Highly prone to neoplastic transformation
  • Often atrophied
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3
Q

What age should testicles be descended?

A
  • Usually descended by 30-40 days
  • Anecdotally delayed in some breeds
  • Unequivocal diagnosis after 6 months
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4
Q

T/F: Cryptorchidism is genetically transmitted

A

TRUE

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5
Q

How do you find prescrotal testicles?

A
  • Usually palpable in SQ
  • Between inguinal ring and scrotum
  • To remove, incise directly over testicle
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6
Q

How do you find inguinal and abdominal testicles?

A
  • Abdominal U/S to locate
  • Exploratory laparotomy
  • To remove abdominal testicle–caudal celiotomy incision
    • Skin incision adjacent to prepuce
    • Divide preputial muscle, vessel
    • Midline incision
    • Follow testicular artery or vas deferens
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7
Q

How is testicular torsion diagnosed?

A
  • More common with abdominal testicles
  • Clinical signs vary
    • Mild signs (anorexia, lethargy)
    • Acute abdomen (marked pain, shock)
  • Diagnosis by U/S, palpation
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8
Q

T/F: Testicular torsion is fatal without surgical treatment

A

TRUE

Surgical emergency!

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9
Q

T/F: Prognosis of testicular torsion is poor, even after surgery

A

FALSE

Prognosis good after surgery

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10
Q

Are cryptorchid testicles prone to neoplastic transformation?

A

YES

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11
Q

Can neoplastic testicles be functional?

A

YES

  • Feminism syndrome–sertoli cell
    • Alopecia, prostate disease, gynecomastia
    • Bone marrow suppression–poor prognosis
  • Testosterone–interstitial cell
    • Perineal hernia
    • Perianal adenoma/adenocarcinoma
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12
Q

What staging workup should be performed with testicular neoplasia?

A
  • CBC/chem/UA
  • 3-view thoracic rads to check for metastasis
  • Abdominal rads/ultrasound to check for metastasis
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13
Q

What is the likelihood of metastatic disease in canine testicular neoplasia?

A

Metastasis is rare (<10%)

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14
Q

Which surgical procedures are recommended for treatment of un-metastasized neoplasia?

A

Bilateral castration with scrotal ablation (complete removal of the scrotum)

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15
Q

What is the prognosis with surgical treatment of un-metastasized neoplasia?

A

If no mets, surgery may be curative

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16
Q

What is scrotal ablation?

A

Complete removal of the scrotum

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17
Q

T/F: Scrotal ablation requires castration

A

TRUE

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18
Q

What is hypospadias?

A
  • Incomplete formation of the penile urethra
  • Most common developmental anomaly of the external male genitalia
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19
Q

What species is hypospadias most common in? What are the signs?

A
  • Most common in Boston Terriers
  • Signs dependent on location
    • Minimal signs
    • Urine scalding
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20
Q

What is paraphimosis?

A

Inability to retract penis into prepuce

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21
Q

What are the congenital causes of paraphimosis? What are the acquired causes?

A
  • Congenital
    • Narrowed orifice
    • Shortened prepuce
  • Acquired
    • Trauma
    • Infection
    • Priapism (persistent and painful erection)
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22
Q

What are the medical treatments for paraphimosis?

A
  • Lube
  • Hyperosmolar solutions–reduce swelling
  • Cold/heat
  • Prognosis dependent on duration
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23
Q

What is phallopexy?

A
  • Surgical treatment for paraphimosis–recurrent cases
    • Paired incision made in mucosa
    • Dorsal midline of the penis
    • Dorsal midline of the prepuce
    • Close defects to each other–tack the penis into the prepuce
    • 3-0 or 4-0 absorbable monofilament
    • Simple interrupted or continuous pattern
    • If there is necrosis of the penis you will have to amputate
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24
Q

What procedure is indicated for tumors of the penis?

A
  • Penile amputation
    • Indicated for most causes of trauma or neoplasia
    • Resection dependent on location/extent of disease
25
Q

What are the common tumor types arising from the penis?

A
  • TVT–not usually treated surgically
  • Papilloma
  • Squamous cell
  • Mast cell tumor
26
Q

T/F: TVT is not treated surgically

A

TRUE

27
Q

T/F: Preputial MCT’s are the least malignant MCT sites

A

FALSE

28
Q

What are the 2 components necessary for reconstruction of the prepuce?

A

Epithelial surface (local, haired skin)

Mucosal surface (usually oral cavity)

29
Q

What are the PE findings and clinical signs of benign prostatic hyperplasia (BPH)?

A
  • Normal aging change
  • Clinical signs
    • dyschezia (difficult or painful defecation)
30
Q

How do you diagnose BPH?

A

Palpation and U/S

  • Palpation–symmetrically enlarged, pain-free prostate
  • U/S shows characteristic homogenous enlargement of prostate
31
Q

How do you differentiate BPH from other prostatic disease?

A
  • Differentiate based on palpation and U/S
  • All looks very uniform, unlike neoplastic conditions
32
Q

How is BPH treated?

A

Castration

33
Q

What are the 2 components in the etiology of prostatitis?

A
  • Ascending infection from the urethra (E. coli most common organism)
  • Pre-existing BPH required
34
Q

What are the clinical signs of prostatitis?

A
  • Dyschezia
  • Pain on urination/defecation
  • Purulent penile discharge
  • Signs of illness: anorexia, lethargy, fever
  • Severe cases: septic shock, peritonitis
35
Q

How do you differentiate prostatitis from other prostatic disease based on ultrasound and palpation findings?

A
  • Ultrasound
    • Heterogenous prostate
    • Pathognomonic flocculent fluid appearance
  • Rectal palpation
    • Bilobed, symmetrical prostate
    • Prostate very painful
    • Palpate carefully, do not rupture
36
Q

What are the ramifications of severe cases of prostatitis?

A
  • Might need aggressive resuscitation
  • MIght need hospitalization
  • Will have to go into abdomen to address the problem
37
Q

What is the surgical treatment for mild cases of prostatitis?

A
  • Systemic antibiotics
  • Fluid support
  • Castration
38
Q

What is omentalization of the prostate?

A

Bringing omentum into or through abscess cavity

Omentum improves drainage

39
Q

What is the typical signalment of a dog with prostatic cysts?

A

Older, intact male dogs

40
Q

What are the clinical signs of a dog with prostatic cysts?

A
  • Large, discrete mass in caudal abdomen
  • May be asymptomatic–incidental finding
41
Q

How do you differentiate prostatic cysts from other prostatic diseases based on ultrasound and clinical signs?

A
  • “Double bladder” on ultrasound
  • Fluid aspiration
    • Brown, watery fluid
    • May become secondarily infected
42
Q

What procedure is indicated for smaller cysts or with limited attachment?

A

Surgical resection

43
Q

Which procedure is indicated with large cysts or with capsular/urethral communication?

A

Partial resection and omentalization

44
Q

T/F: Castration is indicated with any prostatic cyst

A

TRUE

45
Q

What is the prognosis for treatment of prostatic cysts?

A

Good

46
Q

Can surgery for the treatment of prostatic cysts result in urinary incontinence?

A

NO

Urinary incontinence is due to the cyst, NOT the surgery

Cyst causes anatomic changes in the urethra

47
Q

What is the most common type of prostatic neoplasia?

A
  • Usually malignant
    • Adenocarcinoma, various subtypes
    • 80% havfe metastasis on necropsy
48
Q

T/F: Most patients with prostatic neoplasia have metastatic disease at the time of diagnosis

A

TRUE

49
Q

What is the effect of castration on the incidence of and prognosis for prostatic neoplasia?

A
  • Increased incidence
  • Increased risk of metastasis
  • Castration neither palliative nor effective
50
Q

What are the clinical signs compatible with prostatic neoplasia?

A
  • Dysuria
  • Hematuria
  • Urinary retention
  • Dyschezia–renal compression
  • Wt. loss, lethargy, pain
  • Lameness common due to bone metastasis
51
Q

Why is surgical treatment not typically pursued for prostatic neoplasia treatment?

A

Not an easy or straightforward procedure

Will usually introduce complications like incontinence

52
Q

What is the palliative treatment for prostatic neoplasia?

A

Tube cystotomy or urethral stent

53
Q

What is ligated and divided during vasectomy?

A

Prescrotal incision–>little incision in prepuce–>incise down to spermatic cord

Double ligate ductus deferens

54
Q

Why does a vasectomy have no effect on testosterone-related disease?

A

Vasectomy only affects fertility

(Causes animals to ‘fire blanks’)

55
Q

T/F: When neutering a cryptorchid patient, you should always remove the abnormal testicle first

A

TRUE

56
Q

T/F: When ligating a testicle after testicular torsion, you should de-rotate the testicle prior to ligation

A

FALSE

Do NOT de-rotate the testicle

57
Q

What are the indications for surgical treatment of paraphimosis?

A
  • Recurrent condition
  • Small diameter preputial opening
  • Necrosis
58
Q

How do you surgically treat congenital paraphimosis?

A
  • Enlarge preputial orifice
  • Advance prepuce
  • Partial penile amputation may be necessary
59
Q

How do you surgically treat acquired paraphimosis?

A
  • Treat underlying condition
  • Castration if intact (esp. for priapism)
  • Phallopexy if persistent
  • Penile amputation if necrosis present

Small animal surgery I (25 decks)

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