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Case Reports
. 2021 Apr 16;11(4):1145.
doi: 10.3390/ani11041145.

Segmental Posthetomy in a Four Stallions Case Series

Adriana Palozzo  1 , Gianluca Celani  1 , Giulia Guerri  1 , Paola Straticò  1 , Vincenzo Varasano  1 , Lucio Petrizzi  1
Affiliations
Case Reports

Segmental Posthetomy in a Four Stallions Case Series

Adriana Palozzo et al. Animals (Basel). .

Abstract

Segmental posthetomy, also referred to as circumcision, reefing or posthioplasty, consists of removing a circumferential segment of the internal preputial lamina (internal preputial fold) followed by end-to-end anastomosis of skin edges. The purpose of this case series is to describe the successful outcome of segmental posthetomy for treating different diseases involving the internal or/and external preputial fold, while restoring the normal telescopic function. In this paper, we report the first case of complete degloving injury of the equine penis in the literature (case 1) and describe three different common lesions of the equine prepuce/penis (preputial scar tissue in case 2, preputial sarcoid in case 3 and penile/preputial wound in case 4). The amount of prepuce (safe minimums) that can be removed from a stallion without disrupting the proper telescopic function of the internal/external preputial fold and normal copulatory ability, has not been established. In this case series, all Equidae stallions maintained the telescopic function after preputial surgical resection. However, the surgeon must carefully evaluate every single case, especially when performing the Adam's procedure.

Keywords: equine; penis; prepuce; preputial fold; segmental posthetomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Median-sectional schematic drawing of the equine penis inside the prepuce. (a) glans penis; (b) free part of the penis; internal preputial fold (internal lamina): (c) inner lamina of the internal fold, (d) preputial ring, (e) outer lamina of the internal fold; external preputial fold (external lamina): (f) inner lamina of the external fold, (g) outer lamina of the external fold.
Figure 2
Figure 2
Schematic drawing of the external aspect of the equine penis protruded from the prepuce. (a) glans penis; (b) free part of the penis; (c) inner lamina of the internal fold; (d) preputial ring; (e) outer lamina of the internal fold; (f) inner lamina of the external fold; (g) outer lamina of the external fold.
Figure 3
Figure 3
Appearance of the preputial laceration on admission (clinical case 1). The underlying penile tunics were not involved.
Figure 4
Figure 4
Appearance of the phimosis caused by preputial mass on admission (clinical case 2).
Figure 5
Figure 5
Appearance of the preputial mass after traction on the free portion of the penis, the horse was unable to protrude the penis, through a scarred outer lamina of the internal preputial fold and preputial ring (clinical case 2).
Figure 6
Figure 6
Appearance of the preputial mass on admission (clinical case 3).
Figure 7
Figure 7
Appearance of the preputial mass after traction on the free portion of the penis (clinical case 3).
Figure 8
Figure 8
Penile/preputial wound on admission (clinical case 4).
Figure 9
Figure 9
Appearance of the penile/preputial wound at the external physical examination (clinical case 4).
Figure 10
Figure 10
Complete degloving injury of the penis and primary surgical closure (clinical case 1).
Figure 11
Figure 11
Failure of primary closure on the 12th day after surgical repair (clinical case 1).
Figure 12
Figure 12
Subtotal preputial resection (clinical case 1).
Figure 13
Figure 13
Levels of incisions of segmental posthetomy.
Figure 14
Figure 14
Extensive segmental posthetomy (clinical case 1).
Figure 15
Figure 15
Appearance of the preputial mass after resection (clinical case 2).
Figure 16
Figure 16
Appearance of the preputial mass after resection (clinical case 3).
Figure 17
Figure 17
Penile/preputial wound after segmental posthetomy and reconstruction (clinical case 4).
See this image and copyright information in PMC

References

    1. Schumacher J. Penis and Prepuce. In: Auer J.A., Stick J.A., Kümmerle J.M., Timo Prange T., editors. Equine Surgery. 2nd ed. W.B. Saunders; Philadelphia, PA, USA: 2019. pp. 1034–1064.
    1. Peyton L.C. The reefing operation in large animals (A pictorial essay) Vet. Med. Small Anim. Clin. 1980;75:114–117. - PubMed
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