Urogenital Ch 111, 112 Flashcards
de Vlaming JAVMA 2019
Clinical characteristics, classification, and surgical outcome for kittens with phimosis: 8 cases (2009–2017)
OBJECTIVE To describe clinical characteristics and surgical outcomes for kittens with phimosis and to develop a system to classify phimosis on the basis of gross pathological lesions. ANIMALS 8 kittens with phimosis.
PROCEDURES Medical record databases of 2 veterinary teaching hospitals were searched to identify records of cats ≤ 20 weeks old (ie, kittens) with phimosis that underwent surgical intervention
RESULTS The most common clinical signs were stranguria (n = 6), marked preputial swelling (5), and a small (6) or inevident (2) preputial orifice.
Six kittens had type 1 phimosis (generalized preputial swelling owing to urine pooling without penile-preputial adhesions) and underwent circumferential preputioplasty.
Two kittens had type 2 phimosis (focal preputial swelling and urine pooling in the presence of penile-preputial adhesions) and underwent preputial urethrostomy.
No postoperative complications were recorded for kittens that underwent preputial urethrostomy.
All 6 kittens that underwent circumferential preputioplasty had some exposure of the tip of the penis immediately after surgery, which typically resolved over time.
At the time of last follow-up (mean, 1.4 years after surgery), all 8 patients were able to urinate and had no signs of phimosis recurrence.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that circumferential preputioplasty and preputial urethrostomy could be used to successfully manage kittens with type 1 and type 2 phimosis, respectively.
Milgram JSAP 2019
A proposed technique for one-step preputial reconstruction in the dog
Objective: To describe a reverse axial pattern flap based on the superficial branch of the dorsal penile artery and describe its use in preputial reconstruction.
Materials and Methods: Ten penises were harvested from canine cadavers; five were used to describe the dermatome supplied by the superficial branch of the dorsal artery of the penis and five to show perfusion of the skin flap. The superficial branch of the dorsal artery of the penis was identified fluoroscopically by injecting contrast material into the dorsal artery of the penis. This artery was then catheterised and injected with methylene blue to identify the perfused area. A skin flap was created by making a full thickness skin incision at the level of the fornix, along the circumference of the penis. The flap was developed by pulling the cut end toward the tip of the penis while undermining the skin. The flap was considered long enough when the cut end of the flap reached the level of the urethral opening. We also describe a case of preputial resection and reconstruction using this flap.
Results: Injection of methylene blue demonstrated the arterial supply to the skin flap. This flap was successful in treating the clinical case following resection of a mast cell tumour on the prepuce, although a small area of full thickness flap necrosis, which healed by second intention, developed postoperatively.
Clinical Importance: This technique may be useful for single step preputial reconstruction.
Yiapanis Vet Surg 2021
Cranial translation of the elevated prepuce in dogs before and after two modifications: A cadaveric study
Objective: To quantify cranial translation of the prepuce after elevating it from the ventral body wall and to compare it to the cranial translation achieved after each of two modifications expected to increase cranial translation.
Study design: Cadaveric study.
Sample population: Ten male dogs.
Methods: All procedures were performed with dogs in dorsal recumbency. A urinary catheter with an attached millimeter scale was secured in the urethra and the penis was sutured to the ventral body wall to eliminate relative movement between the penis and prepuce. Three preplaced sutures between the prepuce and linea alba, at increasing distances from the prepuce, were used to translate the prepuce cranially. The prepuce was tested after elevating it from the ventral body wall, and after sequentially releasing the skin caudal to the prepuce (modification 1) and the attachment of the lamina interna to the penis (modification 2). The preplaced sutures were tightened and loosened sequentially from caudal to cranial, and the location of the dorsal aspect of the preputial opening on the millimeter scale was noted prior to, and after tightening each of the sutures.
Results: Maximum mean (range) cranial translation of the prepuce after elevating the prepuce, and after modifications 1 and 2, was 15 mm (5–26 mm), 25 mm (15–30 mm), and 37 mm (24–50 mm), respectively.
Conclusion: Modifications described increased cranial translation of the prepuce.
Clinical significance: Modifications described in this study may provide alternate strategies for the treatment of dogs with severe paraphimosis.
Ibrahim Vet Surg 2022
Arterial supply to the scrotum: A cadaveric angiographic study
Objective: To determine the dominant arterial supply to the scrotum.
Study design: Experimental anatomic study. Animals: Intact male canine cadavers (n = 10).
Methods: Barium sulfate was injected into the internal iliac artery (n = 7) or into the pudendoepigastric trunk (n = 3). The perineal, scrotal, and prescrotal skin was sharply dissected from cadavers and radiographed. Angiograms were subjectively reviewed by 3 investigators.
Results: Angiograms were completed successfully in all 10 dogs, with no difference between frozen and fresh cadavers.
The dominant blood supply to the scrotum was consistently identified as arising from the ventral perineal arteries, originating from the internal pudendal arteries, coursing ventrally and cranially toward the caudal scrotum before terminating as the dorsal scrotal arteries (n = 7).
The blood supply to the cranial scrotum was more limited (n = 3) as only the cranial border of the scrotum was perfused by the ventral scrotal arteries.
Conclusion: Based on this anatomic perfusion study, the dorsal scrotal arteries appear to supply a larger area than the ventral scrotal arteries.
Clinical significance: These results provide evidence to justify further consideration of a scrotal flap using the caudal perineal skin as the main cutaneous pedicle to reconstruct defects located on the caudal, medial, and lateral thighs in dogs. Such a flap should be based on the caudal blood supply and the base of this flap should be located caudal to the scrotum to preserve its main blood supply.
Ritson JSAP 2023
The indications, complications and outcomes of dogs undergoing partial penile amputation: 10 cases (2014-2021)
Ten dogs were included in the study.
Indications for surgery were treatment of preputial neoplasia (n=5), penile neoplasia (n=1), idiopathic paraphimosis (n=3) and chronic urethritis (n=1).
Five of five preputial tumours were cutaneous mast cell tumours, and the penile tumour was a squamous cell carcinoma.
All dogs recovered uneventfully from surgery with a median postoperative hospitalisation time of 28.8 hours.
Two of the three dogs treated for paraphimosis had major postoperative complications requiring further resection of the tip of the penis at 2 weeks and 24 months.
Four dogs had minor complications managed without surgical intervention. The outcome was good to excellent in nine of nine dogs for which medium- or long-term follow-up data were available.
Clinical Significance: In this group of dogs, partial penile amputation, performed with or without concurrent resection of the prepuce, was a well-tolerated surgical procedure with low intraoperative and postoperative complication rates and good functional outcomes. Partial penile amputation should be considered for conditions affecting the distal penis and prepuce.
Zink JAVMA 2023
Vasectomy and ovary-sparing spay in dogs: comparison of health and behavior outcomes with gonadectomized and sexually intact dogs
OBJECTIVE To compare health and behavior outcomes for dogs that underwent vasectomy or ovary-sparing spay (hysterectomy) with sexually intact dogs or dogs that had undergone traditional castration or spay. SAMPLE 6,018 dog owners responded to a web-based survey between November 3, 2021, and January 7, 2022. PROCEDURES Participants were asked demographic questions and to provide information about 1 or more dogs (living or deceased). Options for reproductive status were as follows: sexually intact, castrated, spayed (ovariohysterectomy or ovariectomy), vasectomy, or ovary-sparing spay (hysterectomy). Participants were asked questions about orthopedic and other health problems, cancer, and problematic behavior. Logistic regression models, survival analyses, and descriptive statistics were used to assess relationships between reproductive status and outcomes. RESULTS Owners provided valid surveys for 6,018 dogs, including 1,056 sexually intact, 1,672 castrated, and 58 vasectomized male dogs and 792 sexually intact, 2,281 spayed, and 159 female dogs that had undergone ovary-sparing spay. Longer exposure to gonadal hormones, regardless of reproductive status, was associated with reduced odds of general health problems and both problematic and nuisance behaviors. CLINICAL RELEVANCE To our knowledge, this study provides the first data on health and behavior outcomes of vasectomy and ovary-sparing spay in dogs and is the first to compare these outcomes to sexually intact and gonadectomized dogs. It adds to accumulating data on the mixed benefits and risks of removing the gonads to prevent reproduction and emphasizes the importance of developing an informed, case-by-case assessment of each patient, taking into consideration the potential risks and benefits of spaying or neutering and alternative reproductive surgeries.
David Vet Surg 2023
Single Port Laparoscopic assisted abdominal cryptorchidectomy in 14 dogs
Procedure was successful, one dog needed conversion to open surgery due to bleeding from testicular artery
Restrepo JFMS 2019
CT characterisation of the feline os penis
Look at the images in the paper, don’t confuse the os penis with a stone obstruction
