Midbody penile urethrocutaneous fistula repaired by fistulectomy and urethral anastomosis in a stallion.

A unique urethral surgery on a horse with a penile injury was successfully performed, leading to normal urination and mating ability.

Research Background

• The article details a medical case concerning a 12-year-old Friesian stallion that had endured a preputial injury for a year. A complication of this injury, a urethrocutaneous fistula, had developed, causing the horse to urinate abnormally through a fistula (a hole or passageway) in the penis rather than through the urethra.
• The location of the fistula was at the midbody of the ventral, or underside, aspect of the penis.

Diagnosis

• Physical examination revealed the fistula opening, clearly visible at 12 cm from the distal opening of the urethra on the ventral left side of the penis.
• An endoscopic examination further confirmed a blind pouch in the distal portion of the urethra with no communication with either the fistula or the proximal part of the urethra, showcasing a severe disruption in the horse’s urinary system.

Surgical Treatment

• The article outlines the surgical procedure employed. First, a temporary perineal urethrostomy was performed to divert urine from the site where urethral reconstruction was planned.
• The main operation involved a fistulectomy to remove the fistula, besides urethral resection and anastomosis, which refers to the surgical cutting and subsequent connection of healthy ends of the urethra.

Postoperative Actions & Observation

• An endoscopic examination was performed 15 days post-surgery, which revealed some distortion at the fistulectomy site. To correct this distortion, the urethra was periodically dilated for three days.
• A follow-up endoscopic review conducted seven days later showed that the anastomosis site had successfully healed, and the urethral luminal diameter was sufficiently large.
• Long-term follow-up 36 months post-surgery indicated positive results. The owner reported that the horse had resumed normal urination and had also successfully fathered multiple foals through live cover matings.

Conclusion

• Typically, severe preputial or penile traumas in horses result in appendage amputation due to fears about postoperative urethral stricture and occlusion.
• According to the authors, this case represents an unprecedented success story where an end-to-end anastomosis effectively repaired the distal portion of the urethra, preserving the penis and normal urinary function of the stallion.