Testis: cryptorchidectomy - ventral midline approach in Horses (Equis) | Vetlexicon
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Testis: cryptorchidectomy – ventral midline approach

ISSN 2398-2977


Introduction

  • Unilateral cryptorchids can be used for breeding but as the condition is hereditary this should be actively discouraged and castration of both testicles recommended Testis: cryptorchidism.
  • Bilateral cases should be castrated as hormonal and surgical treatments to effect descent are unethical and often unsuccessful.
  • Abdominally retained testes may have an increased incidence of neoplasia Testis: neoplasia - overview.

Uses

Advantages

  • Both abdominal testicles can be removed.
  • Secure closure of incision.
  • Maximum exploration of abdomen is possible - allows access to testes at remote and unusual sites within the abdomen.

Disadvantages

  • Allows removal of abdominal testicles only - not suitable for removal of inguinally retained testes.
  • Considered more invasive than inguinal/parainguinal and may → increased post-operative complications.

Alternative techniques

Time required

Preparation

  • General anesthesia induction and maintenance: 20 min.
  • Aseptic preparation: 10-15 min.

Procedure

  • 30-90 min.

Decision taking

Criteria for choosing test

Risk assessment

Requirements

Personnel

Anesthetist expertise

  • Expertise in equine general anesthesia.

Materials required

Minimum equipment

  • Standard surgical kit.
  • Emasculator.
  • Hand-held retractors.

Minimum consumables

Castration
  • 1 or 2 synthetic absorbable suture material, eg polyglactin 910 or polydioxanone Surgery: suture materials - overview.
  • Double 2 synthetic absorbable suture material, eg polyglactin 910 or polydioxanone Surgery: suture materials - types.
  • 2/0 synthetic absorbable suture material, eg polyglactin 910 or polydioxanone.
  • 0 synthetic non-absorbable suture material, eg polyproylene or skin staples.

Preparation

Pre-medication

Dietary preparation

Site preparation

  • Ventral midline.
  • Standard aseptic preparation (clean, shave, swab, drape) Surgical asepsis and scrubbing.
  • Temporarily suture prepucial orifice to minimize contamination of the operative site.

Restraint

Technique

Approach

Step 1 - Standard method

  • In unilateral cryptorchids a search for and removal of the cryptorchid testicle should precede emasculation of the descended testicle.
Removal of the descended testicle alone increases the potential for fraud by unethical owners and also allows increased growth of the cryptorchid testicle by removing the negative feedback on the pituitary gland. Both testicles should be removed.

Step 2 - Skin incision

Core procedure

Step 1 - Locate testicle

  • The testicle or accessory structures are usually encountered near the deep inguinal ring.
  • The ductus deferens is also palpable in the genital fold of the bladder and can be followed to the testicle.

Step 2 - Castrate

  • Once testicle is located and exteriorized, castrate using the emasculatorTestis: cryptorchidectomy inguinal 05 Testis: castration - technique.
  • OR if the vascular pedicle is short, ligate with 0 synthetic absorbable suture material and sever with scissors Testis: cryptorchidectomy inguinal 04.

Exit

Step 1 - Wound closure

Step 2 - Castrate normal testicle

Aftercare

Immediate Aftercare

General Care

  • Monitor 2-3 times daily for pain and evidence of evisceration Testis: castration - post-operative complications.
  • Restrict exercise for 7 days post-operatively.
  • Thereafter exercise in hand for 4-6 weeks (5-10 min walking 3 times daily increasing gradually to 15 min 3 times daily walk/trot).
  • Restricted area paddock rest for 4-6 weeks, then resume normal activities.

Potential complications

Long term Aftercare

Follow up

Outcomes

Complications

Reasons for treatment failure

Prognosis

  • Good.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Kilcoyne I & Spier S J (2021) Castration complications: a review of castration techniques and how to manage complications. Vet Clin North Am Equine Pract 37 (2), 259-273 PubMed. 
  • Owens C D, Hughes K J, Hilbert B J et al (2018) Survey of equine castration techniques, preferences and outcomes among Australian veterinarians. Aust Vet J 96 (1-2), 39-45 PubMed.
  • Kilcoyne I (2013) Equine castration: a review of techniques, complications and their management Equine Vet Ed, 476-482 AAEP.
  • Searle D, Dart A J, Dart C M & Hodgson D R (1999) Equine castration: review of anatomy, approaches, techniques and complications in normal, cryptorchid and monorchid horses. Aust Vet J 77 (7), 428-434 PubMed. 

Other sources of information

  • Russell T M & Pollock P J (2011) Cryptorchid Castration. In: Equine Reproduction. 2nd edn. Eds: McKinnon A O, Squire E L, Varner D D & Vaala W E. Blackwell Publishing Limited, USA. pp 1531-1539.
  • Shumacher J (1992) Cryptorchid Castration. In: Equine Surgery. Ed: Auer J A. W B Saunders, USA.