How to – Penile translocation

Indications

Penile translocation is performed as part of a teaser bull procedure. The goal is to minimize intromission and minimize disease transmission.

Relevant anatomy

The preputial opening is moved above the flank fold so that the erection misses the vagina. The penis is not usually observed in this procedure.

The prepuce is minimally attached to the body wall. It can be readily dissected free.

Preoperative management

Food restrictions: Withhold food 48 hours. Water should be withheld if the animal is drinking excessively.

NSAIDs/analgesics: Preoperative NSAIDs are recommended.

Antibiotics: The procedure tends to be contaminated. Give preoperative antibiotics.

Local blocks: An inverted U line block around the prepuce and a ring block around the new exit site.

Position/preparation: The animal is positioned in dorsal recumbency. Inserting a long probe into the prepuce can help identify structures and minimize trauma to the sheath.

Surgery Supplies: 

• Standard surgery instruments
• Probe (optional)
• Sterile rectal sleeve
• Lap sponge forceps

Surgical procedure

• If available, a probe can be inserted into the sheath and the sheath clamped shut. This helps identify the sheath during dissection since the penis is not usually in it (retracted).
• A circular incision is made  around the prepuce, extending full thickness through the skin. The incision will be to body wall on the cranial aspect and to the preputial sheath (but not entering the preputial sheath) on the caudal aspect.
• The incision is continued along the length of the prepuce, again full thickness through the skin but NOT entering the sheath.
• A circle of skin is removed at the new exit site above the flank fold (careful with size- it will expand as soon as the skin is cut free; make the circle smaller than you think you need)
• The sheath is only minimally attached to the body wall. Blunt and sharp dissection are used to remove it from the body wall. Start at the cranial aspect of the sheath to identify the body wall.  From the long incision, dissect subcutaneously around the preputial sheath to the body wall. Try not to enter the sheath.  Try to keep close to the body wall while dissecting the sheath free from the body wall so as to not enter the sheath and to keep the sheath vascularized (blood supply intact). This should result in a prepuce that is freed from the skin and the body wall for sufficient length to move to the new site.

• Create a subcutaneous path from the new site to the prepuce through blunt and sharp dissection.
• Pass a sterile rectal sleeve through the new site and insert the prepuce (with preputial opening) into the sleeve. Pull/push the prepuce through to the new exit site.

• Remove the rectal sleeve and secure the prepuce to the new site using a continuous pattern of 0 absorbable suture. Stop halfway around the opening to prevent a purse string effect

Postoperative care

• Suture removal in 10-14 days
• Sexual rest 60 days

Complications

• Dehiscence, stricture

Videos

​youtube video– penile translocation

Resources