Bovine Reproduction. Группа авторов

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Bovine Reproduction - Группа авторов


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may allow sufficient penile protrusion for semen collection. In my experience (Wolfe), two bulls were able to successfully complete coitus following this surgical procedure. With the bull adequately restrained and following preparation for aseptic surgery, make an elliptical incision through the skin. This incision is made on the ventral sheath sufficiently proximal to the scar tissue to penetrate the lumen of the preputial cavity (Figure 19.46). The diameter of the stoma should be sufficiently large to allow the free portion of the penis to extend, but not sufficiently large that the remaining prepuce may prolapse. Following removal of the elliptical skin, continue dissection through the peri‐penile elastic layers and elevate the prepuce through the opening in the sheath (Figure 19.47). Incise the prepuce (Figure 19.48) and exteriorize the free portion of the penis through the incision (Figure 19.49). Using #0 absorbable suture, appose the skin of the prepuce to the skin of the sheath with a simple interrupted pattern (Figure 19.50). Suture a 2.5‐cm Penrose drain over the free portion of the penis to allow postoperative urine drainage away from the incision (Figures 19.5119.53). Remove the Penrose drain 10 days postoperatively and allow 60 days’ sexual rest prior to attempted semen collection (Figure 19.54).

Photo depicts triangular flap of skin removed from sheath. Photo depicts prepuce elevated through incision in sheath. Photo depicts incision into preputial cavity to create stoma. Photo depicts free portion of penis exteriorized through preputial stoma. Photo depicts preputial epithelium apposed to skin of sheath with interrupted absorbable sutures. Photo depicts penrose drain sutured over free portion of penis. Photo depicts penrose drain over penis through preputial stoma for urine drainage.

      Figure 19.52 Penrose drain over penis through preputial stoma for urine drainage.

Photo depicts postoperative image of bull with preputial stoma. Photo depicts completely healed preputial stoma ready for attempted semen collection.

      Paraphimosis with resultant injury from penile exposure can be managed with a combination of medical and surgical therapy. Because of the inability to completely retract the penis, significant damage to the epithelial layers of the penis occurs (Figure 19.14).

      Soaking the affected areas, as described previously for preputial prolapse, should occur immediately and be continued daily until there is a return to the normal appearance of the tissue. In between the therapeutic soaking the penis is covered with stockinette that has been coated in a suitable ointment (the authors’ preference is one of the commercially available “bag balms”). Realize that three to four weeks of medical management is often required before the tissue is healed and surgery can be performed. Once the superficial layers are healed, a scar revision procedure as previously described to allow the penis normal retraction/extension can be performed.

Photo depicts hematoma location.

      Approximately 50% of bulls with rupture of the tunica albuginea return to breeding soundness without surgical repair of the injured penis. Conservative therapy consisting of absolute sexual rest for a minimum of 60 days (and avoiding extension of the penis) with systemic antibiotic therapy for the first 7–10 days is recommended. Daily hydrotherapy of the swollen sheath


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