Equis ISSN 2398-2977

Penis: hematoma

Contributor(s): Jean Pierre Held, Graham Munroe, Elaine Watson, Madeleine L H Campbell

Introduction

  • Penile injury leading to hematoma formation is relatively common.
  • Cause: mating injuries, especially kicking by mare.
  • Signs: swelling occurs within minutes of injury.
  • Diagnosis: history; clinical signs.
  • Treatment: sexual rest and conservative therapy; some require surgery.
  • Prognosis: good.

Pathogenesis

Etiology

  • Kicks from mare during breeding.
  • Sudden bending of the penis during intromission due to mare movements or during AV collection.

Predisposing factors

General
  • Inadequate restraint of mare during breeding or natural covering.
  • Bending of erect penis.

Pathophysiology

  • Injury, usually during mating → penile hematoma → edema and paraphimosis.
  • Trauma → tearing of subfascial superficial vascular plexus of the penis, or of the corpus cavernosum penis, or of the corpus spongiosum penis, or rupture of the tunica albuginea → hematoma formation.
  • Hematoma formation → rapid swelling at various locations along length of penis → edematous cuffing on body of penis → ventrocaudal deviation → paraphimosis (inability to withdraw penis into prepuce) Penis: paraphimosis.
  • The initial tear/rupture forces also blood into the preputial fascia, causing preputial swelling and exacerbating difficulty in withdrawing the penis into the prepuce.
  • Venous congestion, lymphatic obstruction and inflammation exacerbate the swelling.
  • Progressive preputial/scrotal edema develops → increasing the chances of paraphimosis.
  • Where the hematoma (rarely) results from rupture of tunica albuginea that envelopes the corpus cavernosum penis or corpus spongiosum → urethral stenosis.

Timecourse

  • Rapid onset of swelling after injury.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Archer D C (2013) Reproduction Emergencies. In: Handbook of Equine Emergencies. W B Saunders. pp 153-175.
  • Schmacher J (2012) Penis and Prepuce. In: Equine Surgery. 4th edn. Elsevier. pp 840-866.
  • Hyland J & Chrich S (1995) The use of ultrasonnography in the diagnosis and treatment of a haematoma in the corpus cavernosum penis of a stallion. Aust Vet J 72, 468-469.
  • Varner D (1991) Diseases and Management of Breeding Stallions. In: American Vet Pub. ISBN: 0939674335. pp 295-298.


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