HYPOSPADIAS AND URETHRAL DIVERTICULUM IN TWO GOAT KIDS: A CASE REPORT.
Hypospadias associated with urethral diverticula are sporadically reported in kids and lambs in Pakistan. During January to June 2012, two goat kids, ranging in age between 3-5months, were referred to the Surgery Clinic at the University of Veterinary and Animal Sciences, Lahore, Pakistan. The patients showed signs of dysuria, stranguria and urine scalding associated with fluctuating swellings in the penile region; the diagnosis was hypospadias and urethral diverticulum, since urine had leaked into the subcutaneous tissue of the prepuce, forming leaking pockets (diverticula) in both. The opening of the urethra was located at the penile position in both kids. Testicular and penile hypoplasia was observed in one kid, whereas, no other abnormality was observed in the other. In both cases, permanent penile urethrostomy and diverticulectomy was performed in the region of the defect.
On opening the diverticulum in one goat kid, however, two rudimentary urethral orifices were found, one of which (a blind pouch), was closed using a transfixing ligature, while the other, which communicated with the penile urethra, was surgically opened up for a permanent urethrostomy.. Finally, the urethral epithelium was sutured with the skin using 2-0 Mersilk sutures in a simple interrupted pattern. No post-operative complications were reported by the owners of either animal.
Key words: Hypospadias, goat kids, Pakistan.
Congenital anomalies of the urinary system, such as hypospadias and urethral diverticulum, are reported as sporadic cases in goat kids and lambs (Al-Ani et al, 1998; Dennis and Leipold, 1979; Sharma and Singh, 1995). Hypospadias generally occur as a result of imperfect closure or complete lack of fusion of the urethral grooves during phallus elongation (Kahn et al., 2005; Radostits et al., 2007). Many other congenital anomalies usually co-exist, among which urethral diverticula, urethral stenosis, testicular and penile hypoplasia (Alam et al., 2005), and cryptorchidism are more common (Hayes and Wilson, 1986; Rohatgi et al., 1987). Hypospadias is accompanied by hypoplasia of the corpus cavernosum urethra, causing the urethra to open anywhere along its length at one or more locations (Alam et al., 2005). The hypospadias is thus classified on the basis of anatomic localization such as glandular, penile, scrotal, perineal, or anal (Ader and Hobson, 1978; Kahn et al., 2005).
This case report describes the clinical findings and surgical treatment of hypospadias associated with penile urethral diverticula in two goat kids.
Case Presentation: Two goat kids, ranging in age between 3-5 months, were presented to the Surgery Clinic at the University of Veterinary and Animal Sciences, Lahore, Pakistan, with the complaints of anorexia, mild depression, stranguria and dysuria. The animals showed mild tachycardia (140 beats per minute), however, the rectal temperature and respiratory rates were normal.
On clinical examination, one kid was found to have two urethral diverticula caudal to the tip of the penis, whereas, the other one showed a single inflamed pouch (diverticulum) just beneath the penile tip, with accompanying testicular and penile hypoplasia. Urine dribbling was evident from the prepuce and urethral process through the preputial sheath. Urine leakage also occurred from the caudal aspect of one pouch, thus resulting in obvious urine scalding. Abnormalities such as cryptorchidism, hermaphroditism or bifid scrota were not found in either animal, other than penile hypoplasia with a narrowed urethral process. This was suspected to be the cause of stranguria in one kid. Furthermore, this narrowing of the urethral process and penile hypoplasia restricted urethral catheterization in the kid with the single enlarged, inflamed diverticulum.
Manual compression of the two diverticula occurring in one kid, revealed subcutaneous urine leakage; due to narrowing of the urethral orifice, only scant amounts of urine could be voided from the external urethral orifice. Contrarily, in the other one, with the single diverticulum, fibrous adhesions between the penis and preputial sheath led to failure of attempts to remove urine from the pouch.
MATERIALS AND METHODS
Each animal was sedated using XylazR (Prix Pharmaceuticals, Pakistan), at a dose rate of 0.25 ml per 25 kg body weight. Prior to sedation, atropine sulphate was injected intramuscularly at a dose rate of 0.1-0.4 mg/kg body weight, in order to avoid sinus bradycardia and to reduce gastric and tracheal secretions. The site was then clipped, shaved, aseptically prepared using Pyodine Scrub (Brookes Pharmaceutical Laboratories, Pakistan, Ltd.), and finally draped for surgery.
In the kid with two diverticula, penile urethral diverticulectomy was performed after successful urethral catheterization subsequent to amputation of the urethral process. An elliptical skin incision was given on the ventral border of the diverticula. After incising through the subcutaneous tissue, a hypospadiac urethral opening was identified in the caudal diverticulum, and its patency and communication with the urethra were confirmed. The incision was extended over the urethral mucosa, which was finally sutured with the skin, in order to maintain patency of the permanent urethrostomy; simple interrupted sutures using 2-0 Mersilk were applied in this regard.
Conclusion: In our experience, hypospadias associated with penile hypoplasia and diverticula, may successfully be treated by diverticulectomy and permanent urethrostomy; however, depending on each case presentation, and the presence of adhesions between the penis and prepuce, amputation of the narrowed urethral process may not always facilitate urethral catheterization. In general, referred cases of hypospadias and urethral diverticula are treated without any reported complications.
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|Publication:||Journal of Animal and Plant Sciences|
|Date:||Jun 30, 2013|
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