![]() Walker, in Decontamination in Hospitals and Healthcare, 2014 11.6 Water Safety Group: an integrated or multi-modal approach When this procedure is performed on relatively healthy tissue, the success rate is good however, when it is performed on a badly injured, enlarged, and inflamed prepuce, the subsequent healing process often results in significant scarring, which will require removal by resection and anastomosis at a later date. Healing is complete in approximately 6 weeks, at which time the bull should be examined to determine ability to extend the penis. Postoperative treatment with antibiotics is indicated for 5 days. The tourniquet and the plastic tube are then removed and a smaller tube is placed into the preputial cavity and secured with tape for 7 to 10 days as previously described. The edges of the wound are then apposed with a simple continuous pattern of size 0 polyglycolic acid. If the surgeon prefers, the amputation can be done in stages-that is, one third of the circumference can be incised and then sutured, then the next third, until the amputation is completed. It is imperative that the surgeon incorporate both layers of the prepuce in each suture. These sutures should overlap one another around the entire circumference to control postoperative hemorrhage. Horizontal mattress sutures of size 2 polyglycolic acid are placed around the amputation line. The amputated portion of the prepuce is removed. This incision is made in an oblique plane so that the resultant orifice will be somewhat larger and reduce the risk of postoperative phimosis. If necessary, 2% lidocaine is infiltrated around the prepuce just distal to the tourniquet.Ĭommencing distal to the tourniquet, a circumferential, full-thickness incision is made through the prepuce. A tourniquet is tied around the prepuce proximal to the portion to be amputated. A 16-gauge, 4- to 6-inch needle is passed through the healthy preputial tissue proximal to the prolapse, to retain the tube in position. The largest-diameter plastic tube that will fit is placed within the lumen of the prolapsed prepuce to the depth of the fornix. The prepuce and sheath are prepared for surgery. The preputial hairs are clipped and the skin of the sheath shaved approximately 10 cm proximal to the orifice. The preferred technique is to place the bull in right lateral recumbency under moderate tranquilization or general anesthesia. GREGOR MORGAN, in Current Therapy in Large Animal Theriogenology (Second Edition), 2007 Amputation of the PrepuceĪmputation of the prepuce requires less stringent asepsis than that needed for resection and anastomosis and can be used as a prophylactic procedure to prevent preputial prolapse and to correct chronic preputial prolapse. During the study period, no fever, flank pain or urinary symptoms were recorded and urine culture was negative in both cases. In these cases, ureteropyelography showed ureteral obstruction with severe excretory system dilatation. No technical problems occurred during the endoscopic procedures on the two patients with chronic unilateral obstruction (groups (b) and (c)). Stents were removed without technical difficulties in all cases. The patients were successfully treated with anti-muscarinics until the removal of the stents. In one patient in group (a) and two patients in group (e), frequency/urgency symptoms were recorded. During the study period, no patient reported fever or flank pain. ![]() In all patients belonging to groups (a) and (d), retrograde ureteropyelography performed at the start of the procedure showed bilateral ureteral obstruction with various degrees of excretory system dilatation. No technical problems or violations of asepsis were recorded during endoscopic procedures. ![]() FIORI, in Biomaterials and Tissue Engineering in Urology, 2009 6.3.1 Clinical and operative data
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