Surgery of the Equine Male Reproductive Tract Flashcards
Testis passes into the inguinal canal at … days gestation
270-300
What is the gubernaculum?
Gob is to get the testicles from up by the kidneys all the way down to the scrotum
What are the cranial, middle and caudal parts of the gubernaculum?
Cranial - proper ligament of the testis
Middle – ligament of the tail of the epididymis
Caudal – scrotal ligament
What are the 3 indications for castration in males?
Prevent breeding
Modify behaviour
Neoplasia / inguinal hernia
What are the considerations for castration in males?
Age
Breed / size
Temperament
Season
Describe the pre-operative assessment of males before castration
History - Previous scrotal / inguinal hernia
Good restraint essential
Clinical examination
Auscultation of the heart
Palpation
Why is palpation an essential part of the pre-operative castration assessment?
Are both testes palpable? – cannot castrate unless the answer is yes
Are any hernias palpable?
What are the options for castration?
Standing sedation vs. general anaesthesia
Field anaesthesia vs. GA under theatre conditions
Describe the steps to prepare for standing sedation castration
- Sedation (α2 agonist & opiate)
- Bandage the tail
- NSAIDS (Phenylbutazone or flunixin) & Antibiotics
- Aseptic preparation of the scrotum
- Infiltration of local anaesthesia – cord and surgical incision site
- Repeat scrub of scrotum
Describe the steps to prepare for field anaesthesia castration
- Various anaesthetic combinations
- IV catheter
- Lateral recumbency
- Elevation of upper hindlimb
- Castrate lower testicle first so blood runs away from the surgical site
Which piece of equipment is used for castration, how is it used correctly?
Serra Emasculators – have a part that cuts and another that crushes
Nut to nut!
What are open vs closed castrations?
Open = vaginal tunic entered
Closed = vaginal tunic NOT entered (often involves placing ligature but not always)
Describe the post-op care following castration
Check tetanus status
Antibiotics and NSAIDs
Box rest for 24hrs followed by controlled exercise
Keep away from mares
Following castration when should owners be advised to contact the practice?
Contact the practice if:
- Dripping from the incisions persists > 4hrs or if there is a steady stream of haemorrhage
- Evidence of tissue hanging from the incision
- Marked swelling of the scrotum / stiffness that persists >3 days
- Depression, inappetence or colic
List the potential complications that can occur following castration
Swelling
Haemorrhage
Evisceration
Omental prolapse
Septic funiculitis
Clostridial infection
Septic peritonitis
Penile damage
Hydrocele
Continued masculine behaviour
Incomplete cryptorchid castration
What is a rig?
Cryptorchid male
What is cryptorchidism?
Retention of one testis / both testes along the normal path of descent
Terminology: Complete, Incomplete or Inguinal
How can cryptorchidism be diagnosed on history and clinical exam?
Behaviour
Previous surgery – has someone else previously attempted castration?
Thorough external palpation:
- Sedation
- Are any testicular structures palpable & on which side?
- Are any castration scars palpable?
How is hormone analysis used to diagnose cryptorchidism?
- Horses < 2 y.o. & donkeys of any age - hCG stimulation test
- Horses ≥ 3 y.o. – oestrone sulphate assay
- Anti-Müllerian Hormone (AMH): Granulosa cell tumours and cryptorchids
Describe cryptorchid castration
Always open tunic to ensure the whole testicle is removed
Always remove cryptorchid testicle first
Laparoscopy
Describe direct vs indirect inguinal herniation
Direct = trauma/hole made in the body wall and then gut comes out of this hole
Indirect = hole that is there anyway e.g. inguinal ring, and gut comes out of this hole
When is surgery for inguinal hernias indicated?
Increasing in size
Strangulating (non-reducible)
Strangulating hernia should be considered in all stallions / colts that present with which condition?
Colic
What is the most common type of penile and preputial neoplasia?
Squamous cell carcinoma
How is penile and preputial neoplasia diagnosed?
History & presenting signs
Visual appearance: Proliferative, Ulcerative
+/- biopsy
How is penile and preputial neoplasia treated?
- Medical therapy:
- Cryotherapy
- Topical chemotherapeutic agents - Surgery:
- Local excision
- Reefing
- Partial or en bloc phallectomy - Euthanasia - Suspected metastatic spread
- Distal Phallectomy (Penile Amputation)
How can penile neoplasia be prevented?
Owner education – cleaning sheath regularly (smegma = carcinogenic)
Examination of the penis as part of routine yearly check-up in older geldings
How is penile trauma treated?
Ice packs / cold hosing
NSAIDs & Antibiotics
+/- referral
Provide support to the penis
Suture penis within sheath with umbilical tape
What is priapism?
Persistent erection without sexual excitement
Priapism can occur as a consequence of the administration of which drug?
Acepromazine
How is priapism treated?
IV clenbuterol
Intra-CCP phenylephrine
Lavage CCP
What is paraphimosis?
Inability to retract the penis into the prepuce
If prolonged can lead to pudendal nerve injury
How is paraphimosis treated?
Support /suture in prepuce with umbilical tape
NSAIDs
Massage
What is phimosis?
Inability to protrude the penis
Urinate in their sheath
Treat surgically
