Equis ISSN 2398-2977

Penis: balanoposthitis

Synonym(s): Dourine

Contributor(s): Annalisa Barrelet, Jean Pierre Held, Allan Gunn

Introduction

  • Inflammation of the free body or glans of the penis (balanitis), in association with inflamed laminae of the prepuce (posthitis).
  • Associated definitions:
    • Priaprism: an erection or engorged penis in the absence of sexual stimulation.
    • Paraphimosis: the inability to retract the penis in to the  prepuce.
    • Phimosis: the inability to protrude the penis through the preputial orifice/os.
  • Cause: many potential causes; undoubtedly the most common cause is trauma, typically due to a breeding injury.
  • Signs: typically the penis is pendulous and protrudes from the prepuce; both the prepuce and penis are larger than normal, and/or distorted.
  • Diagnosis: history, clinical signs, visual and physical examination, ultrasonography, hematology and biochemistry, microbiology, biopsy, depending on the likelihood of differential diagnoses.
  • Treatment: dependent on cause; if the penis is enlarged and protruding from the preputial orifice, and/or the prepuce is swollen, reduction of the swelling and support of the organs is of paramount importance.
  • Prognosis: dependent on cause; good if traumatic and dealt with rapidly and aggressively post-insult; decreases with chronicity.
Print off the Owner factsheet on Dourine to give to your clients.

Pathogenesis

Etiology

Predisposing factors

General
  • Traumatic: male horse (stallion), usually in the presence of a mare.

Specific

  • Depends on etiology.

Pathophysiology

  • Inflammation, regardless of inciting pathology, leads to swelling of one or bolth of the penis and prepuce. The dependent position of the organs leads to increased blood flow to the organs and increased permeability of blood vessels.
  • Extravasation of fluid into the interstitial space, leading to greater swelling and further inflammation, and an inflammatory cycle. The inflammatory cascade is exacerbated by the relatively inelastic preputial ring, and the restrictions imposed by the preputial orifice. With time, the chronic inflammation may lead to induration, ischemia and necrosis.

Timecourse

  • Depends on etiology.
  • In traumatic lesions, the tissues may not recover without treatment over a period of days.

Epidemiology

  • Regardless of cause, typically this is sporadic, with the exception of venereally transmitted diseases, especially 'dourine'.

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.
  • Gunn A J et al (2013) Balanoposthitis and paraphimosis in the stallion. A novel support for an inflamed penis and prepuce. Clin Theriogenol (1), 45-55 VetMedResource.
  • Beltaire K A, Tanco V M & Bedford-Guaus S J (2011) Theriogenology question of the month. Trauma-induced paraphimosis. JAVMA 238 (2), 161-164 PubMed.

Other sources of information

  • Horserace Betting Levy Board (2016) Codes of Practice. 5th Floor, 21 Bloomsbury Street, London WC1B 3HF, UK. Tel: +44 (0)207 333 0043; Fax: +44 (0)207 333 0041; Email:enquiries@hblb.org.uk; Website:http://codes.hblb.org.uk.
  • Schumacher J & Varner D D (2011) Abnormalities of the Penis and Prepuce. In: Equine Reproduction II. Eds: McKinnon A O, Squires E L, Vaala W E & Varner D D. Wiley-Blackwell. pp 1130-1144.
  • Koch C, O'Brien T & Livesey M A (2009) How to Construct and Apply a Penile Repulsion Device (Probang) to Manage Paraphimosis. In: Proc Am Assoc Equine Pract. pp 338-341.
  • Frazer G S (2008) Stallion Reproductive Emergencies. In: Proc North Am Vet Conf. pp 106-109.
  • Boero M J (1990) A Simple technique for Conswervative Therapy of Acute Traumatic Paraphimosis in the Horse. In: Proc Am Assoc Equine Pract. pp 625-628.


ADDED