31. Disorders of the penis and prepuce (hypospadias, phimosis, paraphimosis)

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18 Terms

1
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what are the main disorders of penis / prepuce

  • hypospadias

  • phimosis

  • paraphimosis

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hypospadias

congenital abnormal location of urethral opening

<p>congenital <span style="color: red">abnormal location </span>of urethral opening </p>
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classification of hypospadias (based on opening location)

  • glandular

  • penile

  • scrotal

  • perineal

  • anal

<ul><li><p>glandular </p></li><li><p>penile </p></li><li><p>scrotal </p></li><li><p>perineal </p></li><li><p>anal </p></li></ul><p></p>
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Diagnosis of hypospadias

examination of puppy, urine output form unusual orifice

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CS hypospadias

  • urinary incontinence

  • peri-urethral dermatitis

  • recurrent UTIs

  • excessive licking

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cause of hypospadias

  • urogenital fold fail to fuse

  • penile urethra doesn’t develop completely

<ul><li><p>urogenital fold fail to fuse </p></li><li><p>penile urethra doesn’t develop completely </p></li></ul><p></p>
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Tx of hypospadias

surgery

  • scrotal urethrostomy

  • perineal urethrostomy

  • castration + removal of penile tissues and prepuce

  • no surgery if opening close to the tip of penis

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phimosis

inability to protrude the penis

<p>inability to protrude the penis </p>
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causes of phimosis

  • short penis

  • persistent frenulum

  • stricture (neoplasia, inflammation)

  • trauma

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CS of phimosis in dogs

  • licking

  • dermatitis (urine scaling)

  • phallocampisis (spiral or corkscrew type of deviation of the penis.)

  • inability to breed

  • pain

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CS of phimosis in cats

  • dysuria

  • outflow obstruction

  • heamaturia

  • distended bladder

  • balanoposthitis (an inflammation affecting the glans penis and prepuce)

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predisposed factor for phimosis

  • crypthorchid

  • Boston terrier

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Paraphimosis

inability to withdraw penis into the prepuce

<p>inability to withdraw penis into the prepuce </p>
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cause of paraphimosis

  • Testosterone mediated (prepubertal testosterone surge High levels of testosterone can stimulate erections or partial extensions of the penis, which can sometimes lead to paraphimosis due to immature genital anatomy with difficulty retracting the penis)

  • edema of penis

  • small preputial orifice

  • neurological disorders

  • phenotiazine tranquilizers

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CS of paraphimosis

  • dry penis

  • ischemia

  • excoriated penis (become abraded, raw, or wounded)

  • self mutilation

  • stranguria (painful, slow, strained urination)

  • hematuria (blood in urine)

  • anuria (complete absence of urine)

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what is the prognosis for paraphimosis ?

depend on the degree of lesion / trauma, and time passed in this situation

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Tx of paraphimosis

  • cold compress with hyperosmolar solution

  • reposition of penis w/ lubricant

  • surgical opening of prepuce /widening

  • penis amputation if necrosis

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difference between priapism and paraphimosis

priapism = persistent erection

paraphimosis = inability to retract penis