Contributors: Elisa Mazzaferro
Species: Canine | Classification: Diseases
Introduction Pathogenesis Diagnosis Treatment Outcomes Further Reading
Introduction
- Uncommon.
- Cause: road traffic accident/hit by car (RTA/HBC), ballistic impacts, bite wounds, malicious intervention (occasionally).
- Signs: severe hemorrhage, urethral obstruction, dysuria, fractured os penis.
- Diagnosis: history, clinical signs, radiography.
- Treatment: simple repair with sutures to penile amputation depending on severity.
- Prognosis: depends on extent of trauma.
Presenting Signs
- Severe hemorrhage - lacerations involving cavernous tissue.
- Urethral obstruction/dysuria - more chronic cases.
- Fracture of os penis - crush injuries.
Cost Considerations
- Usually managed conservatively at minimal cost but severe cases may require surgical intervention.
Special Risks
- Penile damage may result in urethral damage Urethra: rupture and potential urethral obstruction Urethra: obstruction.
Pathogenesis
Etiology
- RTA (HBC).
- Ballistic impacts.
- Bite wounds.
- Malicious intervention (occasionally).
- Blunt trauma.
Predisposing Factors
General
- Over sexed dog where excessive masturbation → trauma.
Pathophysiology
- Penile trauma and lacerations involving cavernous tissue result in severe hemorrhage.
- More chronic injuries may cause urethral obstruction and dysuria.
- Crush injuries may result in fracture of os penis with further laceration of cavernous tissue.
- Fractures of os penis may result in dysuria.
Timecourse
- Acute signs following injury.
Diagnosis
Presenting Problems
- Penile hemorrhage.
- Dysuria.
Client History
- Penile hemorrhage.
- Dysuria (more chronic injuries).
- Licking prepuce.
Clinical Signs
- Urethral catheterization Urethral catheterization: male is advised to ensure integrity of urinary system.
- Fracture of os penis (crush injuries).
Diagnostic Investigation
Radiography
- Radiographs to provide definitive diagnosis of os penis fracture.
- Retrograde urethrography Radiography: urethrography may be required to identify urethral problems.
Definitive diagnostic features
- Signs.
Differential Diagnosis
- Urinary obstruction Urethra: obstruction :
- Urolithiasis Urolithiasis.
- Neoplasia Urethra: neoplasia.
- Penile neoplasia Penis: neoplasia.
Treatment
Standard Treatment
Simple lacerations of mucosa
- Digital pressure/repair with fine sutures.
- EitherOrthopedic intervention.
OrStent with urethral catheter.
- Amputation of penis with or without scrotal urethrostomy Amputation: penis Urethrostomy.
Monitoring
- Ensure animal able to urinate normally.
May be necessary to place cystotomy tube Cystostomy: tube for a time.
Subsequent Management
Monitoring
- For development of urethral stricture.
Outcomes
Prognosis
- Generally good.
- Severe trauma may require penile amputation.
Expected Response to Treatment
Reasons for Treatment Failure
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Erne J B & McNicholas W T (2009) What is your diagnosis? Urethral obstruction and fracture of the os penis. JAVMA 234 (2), 201-202 PubMed.
- Mahler S P & Wint C E (2004) What is your diagnosis? Urethral trauma. JAVMA 225 (6), 839-840 PubMed.