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

CASE DESCRIPTION

A 12-year-old Friesian stallion was examined because of a 1-year history of preputial injury and urination through a urethrocutaneous fistula located at the midbody of the ventral aspect of the penis.

CLINICAL FINDINGS

Physical examination revealed an opening with a clearly apparent mucocutaneous junction 12 cm from the distal opening of the urethra on the ventral left side of the penis. Endoscopic examination of the distal portion of the urethra confirmed a blind pouch with no communication with the fistula or proximal portion of the urethra.

TREATMENT AND OUTCOME

A temporary perineal urethrostomy was performed with sedation and local anesthesia, with the stallion standing, to divert urine from the urethral reconstruction site. Fistulectomy and urethral resection and anastomosis were performed under general anesthesia with the stallion in dorsal recumbency. At 15 days after surgery, endoscopic examination of the urethra revealed distortion of the urethral lumen at the fistulectomy site. Under sedation, the urethra was dilated for 5 minutes every 12 hours for 3 days. At 22 days after surgery, endoscopic examination of the urethra revealed a healed anastomosis site and a large urethral luminal diameter. At 36 months after surgery, the owner reported that the stallion had normal micturition and had sired multiple foals by live cover matings.

CLINICAL RELEVANCE

Severe preputial or penile trauma in horses is most commonly treated with amputation because of concerns of postoperative urethral stricture and occlusion. To the authors' knowledge, this case represented the first time that a successful end-to-end anastomosis of the distal portion of the urethra has been performed in a stallion.