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The male urogenital system

image of The male urogenital system
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Abstract

The testes are paired ovoid organs normally located in the scrotum and are responsible for producing both the male hormone (testosterone) and the male gametes (sperm). This chapter considers the anatomy and conditions of the testicle, the prostate gland and the penis and prepuce as well as urethrostomy procedures. Canine castration; Prostatic abscess management (intracapsular prostatic omentalization); Partial resection and omentalization for discrete prostatic cysts; Canine penile amputation; Canine scrotal urethrostomy; Feline perineal urethrostomy (PU); Prepubic urethrostomy (PPU).

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Figures

Image of 16.1
16.1 Incision in the left inguinal region of a cat. (a) The retained left testicle is located under the inguinal fat. (b) Traction on the testicle reveals the spermatic cord and castration is performed routinely.

(Courtesy of J. Niles)

Image of 16.2
16.2 Vascular supply to the male urogenital tract. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Image of 16.3
16.3 (a) Urethral prolapse in a young Bulldog. (b) A urethral catheter and Rummel tourniquet (Penrose drain) have been placed. (c) The prolapsed urethral mucosa is resected. (d) The urethral mucosa is sutured to the penile mucosa with simple interrupted absorbable sutures.
Image of Untitled
Image of Untitled
Image of The testicle is exteriorized by incising the spermatic fascia but leaving the parietal vaginal tunic intact.
The testicle is exteriorized by incising the spermatic fascia but leaving the parietal vaginal tunic intact. The testicle is exteriorized by incising the spermatic fascia but leaving the parietal vaginal tunic intact.
Image of The testicle is further exteriorized by breaking the dense connective tissue between the tail of the epididymis and the scrotal wall (scrotal ligament).
The testicle is further exteriorized by breaking the dense connective tissue between the tail of the epididymis and the scrotal wall (scrotal ligament). The testicle is further exteriorized by breaking the dense connective tissue between the tail of the epididymis and the scrotal wall (scrotal ligament).
Image of Adherent adipose tissue is removed from the parietal tunic by brushing from the testicle downwards with a moist surgical swab.
Adherent adipose tissue is removed from the parietal tunic by brushing from the testicle downwards with a moist surgical swab. Adherent adipose tissue is removed from the parietal tunic by brushing from the testicle downwards with a moist surgical swab.
Image of The point at which the spermatic cord is to be ligated may be crushed in artery forceps prior to the placement of a transfixing figure-of-eight ligature through the non-vascular component of the cord.
The point at which the spermatic cord is to be ligated may be crushed in artery forceps prior to the placement of a transfixing figure-of-eight ligature through the non-vascular component of the cord. The point at which the spermatic cord is to be ligated may be crushed in artery forceps prior to the placement of a transfixing figure-of-eight ligature through the non-vascular component of the cord.
Image of Sever the cord immediately above the ligature.
Sever the cord immediately above the ligature. Sever the cord immediately above the ligature.
Image of Grasp and incise the parietal vaginal tunic to allow retraction of the testicle from within the tunics.
Grasp and incise the parietal vaginal tunic to allow retraction of the testicle from within the tunics. Grasp and incise the parietal vaginal tunic to allow retraction of the testicle from within the tunics.
Image of Separate the spermatic cord from the tunics and cremaster muscle.
Separate the spermatic cord from the tunics and cremaster muscle. Separate the spermatic cord from the tunics and cremaster muscle.
Image of Ligate the cremaster muscle and tunics separately; transect immediately above the ligature.
Ligate the cremaster muscle and tunics separately; transect immediately above the ligature. Ligate the cremaster muscle and tunics separately; transect immediately above the ligature.
Image of Exposure of the prostate gland via caudal laparotomy.
Exposure of the prostate gland via caudal laparotomy. Exposure of the prostate gland via caudal laparotomy.
Image of Pus draining from lateral stab incision in prostate gland.
Pus draining from lateral stab incision in prostate gland. Pus draining from lateral stab incision in prostate gland.
Image of ‘Window’ created in lateral aspect of the prostatic abscess.
‘Window’ created in lateral aspect of the prostatic abscess. ‘Window’ created in lateral aspect of the prostatic abscess.
Image of Digital exploration of the abscess cavities.
Digital exploration of the abscess cavities. Digital exploration of the abscess cavities.
Image of Forceps drawing omentum into ventral abscess cavity.
Forceps drawing omentum into ventral abscess cavity. Forceps drawing omentum into ventral abscess cavity.
Image of Omentum in ventral abscess cavity before packing into dorsal cavity.
Omentum in ventral abscess cavity before packing into dorsal cavity. Omentum in ventral abscess cavity before packing into dorsal cavity.
Image of The paraprostatic cyst (arrowed) is exteriorized and the abdomen packed off with swabs.
The paraprostatic cyst (arrowed) is exteriorized and the abdomen packed off with swabs. The paraprostatic cyst (arrowed) is exteriorized and the abdomen packed off with swabs.
Image of A single stab is made into the cyst and its contents are aspirated.
A single stab is made into the cyst and its contents are aspirated. A single stab is made into the cyst and its contents are aspirated.
Image of The majority of the cyst wall is resected.
The majority of the cyst wall is resected. The majority of the cyst wall is resected.
Image of Carcinoma of penile glans.
Carcinoma of penile glans. Carcinoma of penile glans.
Image of Extrusion of the penis with tourniquet around the base.
Extrusion of the penis with tourniquet around the base. Extrusion of the penis with tourniquet around the base.
Image of Incision in penile mucosa.
Incision in penile mucosa. Incision in penile mucosa.
Image of Separation of the urethra from the os penis.
Separation of the urethra from the os penis. Separation of the urethra from the os penis.
Image of Amputation of the penis, leaving an extended section of urethra.
Amputation of the penis, leaving an extended section of urethra. Amputation of the penis, leaving an extended section of urethra.
Image of Oversewing the cavernous tissue to limit bleeding.
Oversewing the cavernous tissue to limit bleeding. Oversewing the cavernous tissue to limit bleeding.
Image of Spatulation of the reflected mucosa over the end of the amputated penis.
Spatulation of the reflected mucosa over the end of the amputated penis. Spatulation of the reflected mucosa over the end of the amputated penis.
Image of Completed urethral repair.
Completed urethral repair. Completed urethral repair.
Image of Bleeding following removal of tourniquet.
Bleeding following removal of tourniquet. Bleeding following removal of tourniquet.
Image of Patient positioned for scrotal urethrostomy.
Patient positioned for scrotal urethrostomy. Patient positioned for scrotal urethrostomy.
Image of Castration with scrotal ablation.
Castration with scrotal ablation. Castration with scrotal ablation.
Image of The retractor penis muscle is identified and displaced laterally to expose the urethra.
The retractor penis muscle is identified and displaced laterally to expose the urethra. The retractor penis muscle is identified and displaced laterally to expose the urethra.
Image of The urethra is incised longitudinally with a No. 11 scalpel blade; the urethral mucosa is identified.
The urethra is incised longitudinally with a No. 11 scalpel blade; the urethral mucosa is identified. The urethra is incised longitudinally with a No. 11 scalpel blade; the urethral mucosa is identified.
Image of Monofilament, non-absorbable suture material (polypropylene) is used to suture the urethrostomy. A swaged-on taper cut needle should be used to minimize the size of the needle tract. The urethrostomy can be sutured using either a simple interrupted or a simple continuous pattern. A simple continuous pattern results in accurate apposition of the urethral mucosa to the skin and helps to achieve haemostasis. If the cranial aspect of the skin incision extends beyond the urethral incision, it should be closed with simple interrupted sutures. The needle should be driven from the urethral mucosa to the skin for best apposition. Each suture should comprise three tissue bites: the urethral mucosa; a 2–3 mm bite of the fibrous tunica albuginea; and a split-thickness bite of the skin.
Monofilament, non-absorbable suture material (polypropylene) is used to suture the urethrostomy. A swaged-on taper cut needle should be used to minimize the size of the needle tract. The urethrostomy can be sutured using either a simple interrupted or a simple continuous pattern. A simple continuous pattern results in accurate apposition of the urethral mucosa to the skin and helps to achieve haemostasis. If the cranial aspect of the skin incision extends beyond the urethral incision, it should be closed with simple interrupted sutures. The needle should be driven from the urethral mucosa to the skin for best apposition. Each suture should comprise three tissue bites: the urethral mucosa; a 2–3 mm bite of the fibrous tunica albuginea; and a split-thickness bite of the skin. Monofilament, non-absorbable suture material (polypropylene) is used to suture the urethrostomy. A swaged-on taper cut needle should be used to minimize the size of the needle tract. The urethrostomy can be sutured using either a simple interrupted or a simple continuous pattern. A simple continuous pattern results in accurate apposition of the urethral mucosa to the skin and helps to achieve haemostasis. If the cranial aspect of the skin incision extends beyond the urethral incision, it should be closed with simple interrupted sutures. The needle should be driven from the urethral mucosa to the skin for best apposition. Each suture should comprise three tissue bites: the urethral mucosa; a 2–3 mm bite of the fibrous tunica albuginea; and a split-thickness bite of the skin.
Image of The proximal urethra is catheterized.
The proximal urethra is catheterized. The proximal urethra is catheterized.
Image of Completed scrotal urethrostomy.
Completed scrotal urethrostomy. Completed scrotal urethrostomy.
Image of Incision surrounding the scrotum.
Incision surrounding the scrotum. Incision surrounding the scrotum.
Image of Dissection and dorsal reflection of the penis.
Dissection and dorsal reflection of the penis. Dissection and dorsal reflection of the penis.
Image of Incision of the ischiocavernosus muscle.
Incision of the ischiocavernosus muscle. Incision of the ischiocavernosus muscle.
Image of Resection of the ischiocavernosus muscle.
Resection of the ischiocavernosus muscle. Resection of the ischiocavernosus muscle.
Image of Resection of the retractor penis muscle.
Resection of the retractor penis muscle. Resection of the retractor penis muscle.
Image of Exposure of penile urethra with urolith and localized cellulitis.
Exposure of penile urethra with urolith and localized cellulitis. Exposure of penile urethra with urolith and localized cellulitis.
Image of Spatulation of the urethral mucosa and cutaneous suturing.
Spatulation of the urethral mucosa and cutaneous suturing. Spatulation of the urethral mucosa and cutaneous suturing.
Image of Urethral stoma after amputation of the penile stoma.
Urethral stoma after amputation of the penile stoma. Urethral stoma after amputation of the penile stoma.
Image of Position of the prepubic incision.
Position of the prepubic incision. Position of the prepubic incision.
Image of Dissection of the bladder neck and urethra.
Dissection of the bladder neck and urethra. Dissection of the bladder neck and urethra.
Image of Elevation of the bladder neck and urethra.
Elevation of the bladder neck and urethra. Elevation of the bladder neck and urethra.
Image of Exteriorization of the resected urethra.
Exteriorization of the resected urethra. Exteriorization of the resected urethra.
Image of Resected urethra anchored in the laparotomy repair.
Resected urethra anchored in the laparotomy repair. Resected urethra anchored in the laparotomy repair.
Image of Complete urethral stoma.
Complete urethral stoma. Complete urethral stoma.

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