Bovis ISSN 2398-2993

Paraphimosis

Synonym(s): Penis, Pripism, Penile paralysis

Contributor(s): Ash Phipps , Mark Burnell

Synergy Farm Health logo

Introduction

  • Cause: trauma, debilitation, inflammation, neoplasia, paralysis or priapism.
  • Signs: swollen penis and prepuce, inability to retract penis into sheath, priapism, penile paralysis.
  • Diagnosis: based on clinical signs.
  • Treatment: reduce edema and inflammation; replace penis; preputiotomy (surgical enlargement of the preputial orifice), phallopexy or phallectomy/ penectomy (removal of the entire or part of the penis).
  • Prognosis: this is dependent of the underlying cause.
  • This article will focus on the medical management of paraphimosis in bulls. 

Pathogenesis

Etiology

  • There are three main mechanisms for the pathogenesis of paraphimosis in bulls:
  1. Preputial edema: penile injury, preputial trauma/lacerations and/or diseases that result in ventral or generalized edema.
  2. Damage to the penile innervation: spinal cord injury and/or a consequence of a penile laceration or hematoma.
  3.  Penile paralysis: paralysis of the penis, consequence of priapism and/or use of acepromazine/phenothiazine tranquilizer.

Predisposing factors

General

  • Trauma to the penis and prepuce  .
  • Inflammation of the penis.
  • Neoplasia of the penis.
  • Inflammation of the prepuce.
  • Infection of the prepuce.

Specific

  • Breed.
  • Excessive amounts of parietal preputial epithelium.
  • Absence or lack of development of the caudal prepuce muscle.

Pathophysiology

  • The general pathophysiology of the condition is either the constriction of the prepuce behind the glans penis or to swelling (inflammatory/edema) of the glans penis which results in the prevention of the organ being withdrawn back through the naturally small preputial orifice:
    • Traumatic injury: false copulation - penis strikes the pevis of the cow or the cow kicks the bull's penis which results in enlargement or swelling (inflammation/edema) of the distal penis, preventing the penis form being retracted back into the prepuce.
    • Neoplasia (malignant or benign): of the penis which results in enlargement or swelling of the distal penis that prevents the penis form being retracted back into the prepuce. 
    • Swelling of the prepuce (inflammatory, edema, or, infectious): resulting in the narrowing of the preputial orifice and, therefore, an inability to retract the penis into the prepuce. 
    • Neurogenic origin, causing paralysis of the penis, and, therefore an inability to retract the penis into the prepuce. This may be due to a spinal injury leading to paralysis of the rectractor muscles.

Timecourse

  • The time course of the condition will be dependent on the underlying cause:
    • Swelling of penis and prepuce occurs within a few hours of paraphimosis​.
    • With traumatic lesions, resolution of the lesion with medical treatment is generally rapid if the condition is observed and treated promptly.
    • If the condition is due to penile paralysis, the resolution may be protracted or even unlikely.

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Desrochers A, St-Jean G & Anderson D E (1995) Surgical management of preputial injuries in bulls: 51 cases (1986-1994).  Can Vet J 36 (9), 553 PubMed.
  • Neal F C (1960) Surgical Problems of the Penis and Prepuce of Bulls, Part II. Iowa State University Veterinarian 22 (3), 5.

Other sources of information

  • Cockcroft P (2015) Bovine medicine. John Wiley & Sons.


ADDED