32. Disorders of the penis and prepuce – balanoposthitis, priapism, urethral prolapse

What is balanoposthitis?

Inflammation of the penis and prepuce

What are some potential consequences of balanoposthitis?

Stenosis of the preputial orifice, adhesions of the penis, pain

In which age group of dogs is balanoposthitis sometimes seen due to an immature immune system?

Young dogs close to puberty

What are some infectious causes of balanoposthitis?

Herpesvirus, calicivirus, ascending or descending bacterial infections

What are some non-infectious causes of balanoposthitis?

Trauma, licking/self-mutilation

What are the clinical signs of balanoposthitis?

Red mucous membranes, green or yellow discharge, painful urination (dripping)

How is balanoposthitis diagnosed?

Presence of discharge, bacterial swab, cytology

What are the treatment options for balanoposthitis?

E-collar, flushing the prepuce with warm saline/antiseptic, enlarging the preputial opening, antibiotics, sexual rest

What is priapism?

A persistent erection lasting more than 4 hours without sexual stimulation and not due to hormones

Is priapism more common in younger or older dogs?

Older dogs

What are some neurological disorders that can cause priapism?

(Not specified in the text)

What are some vascular causes of priapism?

Veno-occlusion due to thrombus, neoplasia, or trauma

What medications can cause priapism?

Phenothiazine tranquillisers, general anaesthesia

What other systemic disease is listed as a potential cause of priapism?

Diabetes

What are the two main types of priapism?

Non-ischaemic (arterial, high flow) and ischaemic (veno-occlusive, low flow)

What are the clinical signs of priapism?

Dysuria, stranguria, haematoma, necrosis

How is priapism diagnosed?

History (drug use), blood tests (metabolic disease, neoplasia, coagulation), urinalysis, X-ray, USG

What are some treatment options for priapism?

Flushing with heparinized saline, infusion with sympathomimetic drugs (phenylephrine), amputation and urethrostomy if severe

Is castration an effective treatment for priapism?

No, it is not hormonally mediated

How does the hormonal basis of priapism differ from paraphimosis?

Priapism is not hormonal, while paraphimosis is testosterone-mediated and related to sexual stimulation

What is urethral prolapse?

The inner lining of the urethra protruding through the urethral opening and becoming oedematous

What are some potential causes of urethral prolapse?

Urethritis, sexual arousal, or masturbation

In which age group and breed is urethral prolapse most common?

Dogs less than 5 months old, especially English bulldogs

What are the clinical signs of urethral prolapse?

Pea-sized red or purple mass at the end of the penis, difficulty urinating, licking, pollakiuria

How is urethral prolapse diagnosed?

Physical examination (intermittent blood drops from the penis tip, visible prolapse)

What are the treatment options for urethral prolapse?

E-collar, sexual rest, tranquillisers, resection of the prolapse or manual reduction with catheterisation and suturing of the urethra to the penis shaft if bleeding or pain is significant

What is pollakiuria?

Abnormally frequent urination.

What is stranguria?

Slow and painful urination.

What is dysuria?

Difficult or painful urination.

What is haematoma in the context of priapism?

A collection of blood within the tissues of the penis.

What is necrosis in the context of priapism?

Tissue death due to prolonged lack of blood flow.