4. male reproductive sx

obstructive signs of prostatic disease

• dyschezia (difficulty defecating)

• “ribbon-like” stool

• stranguria

urinary signs of prostatic disease

• hematuria

• urethral bleeding

• abnormal discharge

• concurrent UTI

regional & systemic signs of prostatic disease

regional

• signs of orthopedic / neurologic abnormalities associated with caudal spine

• disruption of lymphatic or vascular obstruction (rare) — swelling of hindlimb

• pain in caudal abdomen

systemic

• pyrexia (fever)

• evidence of sepsis

benign prostatic hyperplasia signalment & pathogenesis

• signalment: intact male dogs, generally older

• pathogenesis: hormonally driven benign enlargement of the prostate

  • prostatic enlargement is a normal finding in mature intact males

benign prostatic hyperplasia clinical presentation

• many dogs asymptomatic

• tenesmus due to colonic compression is common

• stranguria is uncommon in dogs

benign prostatic hyperplasia treatment & prognosis

• treatment: castration

• prognosis: good; resolution of signs can be seen within days of castration

signalment & pathogenesis of chronic prostatitis

• signalment: typically intact males

• pathogenesis:

  • typically presents with benign prostatic hyperplasia

  • often due to ascending infection

  • generalized inflammation of the prostate

  • cystic changes commonly seen on ultrasound

chronic prostatitis findings

• prostate is usually mildly enlarged, but this is variable

• urinary tract signs

• painful

• e. coli common

chronic prostatitis treatment & prognosis

• treatment: castration & antimicrobials

• prognosis: fair — good

prostatic abscess signalment & pathogenesis

• signalment: intact males

• pathogenesis: may be an extension of acute or chronic prostatitis

prostatic abscess findings

• variable texture on palpation

  • fluctuant at the center (pus); firm around abscess

  • inflammation can be severe and painful

• can be very serious and fatal with systemic sepsis

• may be >1 abscess

prostatic abscess treatment & prognosis

• treatment: castration + surgical drainage (omentalization, passive or active drainage)

• prognosis: guarded — good

prostatic cyst signalment & pathogenesis

• signalment: intact males

• pathogenesis: accumulation of glandular secretions from microscopic cystic changes and disordered drainage

  • associated with benign prostatic hyperplasia

  • lined with an epithelial layer

  • secondary infection possible

  • “paraprostatic cysts” are similar but aren’t attached to the prostate

prostatic cyst findings

large solitary cysts within or surrounding the prostate

• note: cystic changes within the prostate are commonly seen with other prostatic conditions, but development of a single large prostatic cyst is less common

prostatic cyst treatment & prognosis

• treatment: castration + resection with omentalization

• prognosis: guarded — good

what complications are common with treatment of prostatic abscesses or cysts?

• hemorrhage (intra-op or post-op)

• urethral rupture or leakage

• incontinence

• recurrence of disease

• abscesses

  • sepsis

  • ascending pyelonephritis

  • UTI

prostatic neoplasia signalment and pathology

• signalment: any male

• pathology: adenocarcinomas most common

  • typically invades surrounding structures, fixing gland in place

  • metastasis occurs early

    • sublumbar lymph nodes, systemically

prostatic neoplasia treatment & prognosis

• treatment: partial or complete prostatectomy, radiation therapy

  • if urinary tract blocked, stent or cystotomy tube for palliation

• prognosis: guarded

prostatic trauma signalment & history

• signalment: any male

• history: traumatized in animals with pelvic fractures

  • unless the urinary is damaged, often under-appreciated in the face of more severe injuries

prostatic trauma treatment & prognosis

• treatment: unless massive with urinary leakage, doesn’t require treatment

• prognosis: generally good

what is the difference between open and closed orchiectomy?

• closed: parietal vaginal tunic left intact

• open: parietal tunic incised, opening into the peritoneal space

what are advantages of closed castration? open castration?

• closed: faster, less suture left behind, don’t enter peritoneal space

• open: better able to isolate vasculature; in big dogs may help prevent arteries from slipping through ligatures