ISSN 2398-2977      

Penis: paraphimosis

pequis

Introduction

  • Paraphimosis is the inability to retract the penis back into the prepuce.
  • Cause: trauma, myelitis, purpura hemorrhagica   Purpura hemorrhagica  , debilitation, or priapism   Penis: paralysis / priapism  .
  • Signs: swollen penis and prepuce, inability to retract penis into sheath, priapism, penile paralysis.
  • Diagnosis: clinical signs.
  • Treatment: reduce edema and inflammation; replace penis; preputiotomy, phallopexy   Penis: phallopexy  or phallectomy   Penis: phallectomy - Scott's technique  .
  • Prognosis: depends on cause.

Pathogenesis

Etiology

Preputial oedema

Pathophysiology

  • Inability to retract penis into sheath   →   impaired drainage   →   preputial and penile swelling.
  • Penile/preputial injury   →   edema (penis/prepuce)   →   increased weight   →   muscular fatigue of retractor muscles   →   prolapse of penis/internal preputial laminae.
  • Debility   →   loss of muscle tone   →   penile prolapse   →   damage to pudendal nerves.
  • Penile paralysis following phenothiazine derivatives.
  • Inability to retract penis into sheath   →   compromise of venous and lymphatic drainage   →   preputial and penile swelling   →   edema at preputial ring   →   constricts proximal penis   →   further swelling.
  • Accumulation of edema leads to seepage through epithelium   →   fragile   →   wounds   →   infected fissures   →   excoriation and secondary bacterial infection.
  • Fibrous tissue develops   →   impossible to manually replace penis into sheath.

Timecourse

  • Swelling of penis and prepuce occurs within a few hours of paraphimosis.

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

  • Recent references from PubMed and VetMedResource.
  • Feary D J et al (2005) Chemical ejaculation and cryopreservation of semen from a breeding stallion with paraphimosis secondary to priapism and haemorrhagic colitis. Equine Vet Educ 17 (6), 299-304 VetMedResource.
  • McDonnell S M (2005) Managing the paralysed penis, priapism or paraphimosis in the horse. Equine Vet Educ 17 (6), 310-311 VetMedResource.
  • Nie G J & Pope K C (1997) Persistent penile prolapse associated with acute bloodloss and acepromazine maleate administration in a horse. JAVMA 211 (5) 587-589 PubMed.
  • Perkins N R & Frazer G S (1994) Reproductive emergencies in the stallion. Vet Clin North Am Equine Pract 10 (3) 571-638 PubMed.
  • Love C C, McDonnell S M & Kenney R M (1992) Manually assisted ejaculation in a stallion with erectile dysfunction subsequent to paraphimosis. JAVMA 200 (9) 1357-1359 PubMed.
  • Little T V & Holyoak G R (1992) Reproductive anatomy and physiology of the stallion. Vet Clin North Am Equine Pract (1) 1-29 PubMed.
  • Schumacher J & Vaughan J T (1988) Surgery of the penis and prepuce. Vet Clin North Am Equine Pract (3) 473-491 PubMed.

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