Equis ISSN 2398-2977

Penis: phimosis

Contributor(s): Jean Pierre Held, Graham Munroe, Elaine Watson

Introduction

  • Phimosis is the inability to protrude the penis from the sheath.
  • Cause: stenosis of the preputial orifice, eg congenital stricture, trauma, edema, inflammation, or impairment of normal preputial telescoping action.
  • Signs: inability to protrude penis from the sheath, inflammation of the prepuce, excessive smegma accumulation.
  • Diagnosis: signs, biopsy, microbiology, serology and parasitology.
  • Treatment: depends on cause.
  • Prognosis: guarded to fair - depends on cause.

Pathogenesis

Etiology

  • Stenosis of preputial orifice may be caused by:

  • Congenital defects

  • Acquired defects
  • Trauma   Penis: trauma  .
  • Edema.
  • Inflammation.
  • Infection with equine herpesvirus 3   Equine herpesvirus    Reproduction: coital exanthema - EHV 3  orCorynebacterium pseudotuberculosisor lesions at the preputial crevice/ring prevent telescoping action.
  • Genital phycomycosis .
  • Genital cutaneous habronemiasis   Penis: habronemiasis  .
  • Neoplasia   Penis: neoplasia  .
  • Urine retention in the preputial cavity subsequent to phimosis producing further mucosal inflammation and cicatrisation.

Pathophysiology

  • Stenosis of preputial orifice leads to inability to protrude penis from sheath.
  • Impairment of normal preputial telescoping action.
  • Congenital phimosis is normal for the first month of life; the epithelium of the free part of the penis is fused with the inner lamina of the preputial fold. Separation occurs within 1 month of birth.
  • The penis or prepuce may become deformed or fixed by neoplasia   Penis: neoplasia  or granulomas.
  • Trauma or chronic infection may cause inflammation or edema of prepuce (posthitis   Penis: balanoposthitis  )   →   stenosis of preputial orifice .
  • Excessive secretion of smegma   Prepuce: smegma    →   chronic irritation and thickening of prepuce   →   phimosis   →   urination within prepuce   →   exacerbates inflammation.
  • Horses castrated when young may fail to protrude penis when urinating   →   inflammation   →   scarring   →   constriction of preputial orifice   →   phimosis.

Timecourse

  • Usually gradual onset.

Epidemiology

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Perkins N R and Frazer G S (1994) Reproductive emergencies in the stallion. Vet Clin North Am Equine Pract 103 (3), 571-638 PubMed.
  • Little T V and Holyoak G R (1992) Reproductive anatomy and physiology of the stallion. Vet Clin North Am Equine Pract (1), 1-29 PubMed.
  • Simmons H A et al (1985) Paraphimosis in seven debilitated horses. Vet Rec 116 (5), 126-127 PubMed.


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