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World’s First! Endoscopic Prepuce Exam in a Dog

July 18, 2010

Boxer Needs Prepuce Exam

Veterinary medicine presents constant new challenges.  Franklin was one of those challenges.  A handsome, happy 11-year-old Boxer undergoing successful chemotherapy, he had a problem that kept flaring up about 2 days after each chemotherapy treatment.  Franklin would start leaking and dripping gooey green pus from his prepuce.  The prepuce is the skin pouch the penis lives in.  So basically, he was dripping pus from his penis.  But not exactly, because the penis was okay and his bladder was bacteria-free.

Franklin was a typical hyperactive Boxer which made holding him still for a detailed examination impossible.  Doc Truli sedated the old boxer gentleman and proceeded to attempt a prepuce examination.

Normally, the prepuce can be reflected back and the penis extruded for a thorough exam.  We needed to be sure Franklin did not have a metastatic tumor in there, or foreign material like a plant sticker or awn.  But, because of the recurring nature of the problem, the prepuce was stuck, and would not reflect back far enough for a complete examination.

That’s when yours Truli got an idea.

Preputial Endoscopy in a Dog

canine preputial endoscopy

Doc Truli snakes the endoscope into the prepuce

Never one to give up lightly, Doc Truli thought, “Why not use the endoscope to look at the prepuce thoroughly?”

With Franklin under anesthesia, Doc Truli snaked the scoped into the prepuce.  Nothing is very visible this way, because the membranous lining of the prepuce just sits against the camera on the end of the scope and all you see is pink.

Tricky surgeon's hands maneuver the flush and the camera endoscope

Surgeon's hands maneuver the flush and the camera endoscope

Sterile saline flush solution was flushed into the prepuce using an open-ended tomcat catheter and a twenty millilitre syringe (one ounce for Americans.)

prepuce pinch

prepuce pinch

The water would just flush right out, but Doc cleverly pinched the prepuce shut and inflated the space with the saline.

The scope was moved circumferentially around the penis to view the fornix in 360 degrees.  The sterile saline infusion ended up being super useful because filamentous white connective tissue kept blocking the camera view.  The saline flush gently pushed it away to leave room for a clear view.

filamentous preputial material

filamentous preputial material

No foreign bodies or tumors were seen.  Basically, Franklin received an endoscopic-guided preputial flush!

This story is a world-first published description of a canine preputial flush procedure.

Franklin is feeling great and has not had a recurrence of the discharge since the procedure!

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