Segmental Posthetomy in a Four Stallions Case Series

SIMPLE SUMMARY: The equine prepuce is characteristic for having two infoldings that allow for substantial accommodation of the penis during detumescence and permit erection. Segmental posthetomy of the equine prepuce is a well described technique indicated for penile sheath injuries or lesions (neoplasms, granulomas, or scar tissue) that do not involve the underlying penile tunics. This surgical technique can be performed with variable extent of excision (i.e., the Adam’s procedure or subtotal posthetomy). The authors describe their experiences and results with different levels of preputial resection for treating four Equidae stallion patients with different preputial/pathologies. 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.