Partial amputation of the penis with pexy to the ventral abdomen and revision of the peripreputial skin can be used as an alternative to en bloc resection and penile retroversion for lesions involving the free part of the penis and the prepuce. It requires smaller incisions and results in less alteration to the normal appearance of the external genitalia than retroversion techniques, while still allowing the surgeon to remove extensive portions of the penis and extirpate the regional lymph nodes.
Ablation of PEH using formaldehyde solution avoids general anesthesia and problems associated with ablation by conventional surgery or laser.
T he digital flexor tendon sheath (vaginae synoviales tendinum digitorum manus) 1 is a synovial structure that envelops the superficial and deep digital flexor tendons as they pass over the palmar and plantar aspects of the metacarpo-and metatarsophalangeal (fetlock) joints. It extends from the distal portion of the third metacarpal or metatarsal bone to the proximal half of the second phalanx. [2][3][4] The tendon sheath encircles the tendons except at the palmar or plantar aspects of the fetlock canal where the superficial digital flexor tendon is attached to the tendon sheath and forms the palmar or plantar walls of the sheath. 3,5-7 There are 2 major pouches in the sheath; 1 pouch is at the most proximal aspect between the suspensory ligament and the deep digital flexor tendon, and the other pouch is located distally, between the proximal and distal digital annular ligaments, at the bifurcation of the superficial digital flexor tendon. 2-4 The tendon sheath is 14 to 20 cm in length and is composed of an outer fibrous layer that provides the vascular supply to the sheath and an inner visceral layer that contains synoviocytes. 3,5,8 Synoviocentesis is an important technique for the diagnosis and treatment of various infectious, traumatic, and inflammatory disorders of the digital flexor tendon sheath in horses. The most common clinical indication for centesis of the digital flexor tendon sheath is septic tenosynovitis, which develops commonly as a consequence of trauma to the limb; the digital flexor tendon sheath is the most commonly affected site. 3,[9][10][11][12] As with any infectious process, early diagnosis and immediate treatment for septic tenosynovitis are important for successful management. 10 Prompt identification of tendon sheath involvement in lacerations of the distal portions of the limb can be achieved through distention of the tendon sheath with sterile infusing solutions to assess whether communication with a wound exists. 3 Once identified, reliable needle access to the sheath is essential for successful management of septic tenosynovitis by use of intrathecal antimicrobial treatment and lavage. When wounds involving the tendon sheath are actively draining, distention of the tendon sheath may be absent, and access to the tendon sheath is important to establish whether communication with the wound exists. Limitations for access to the tendon sheath may also exist, depending on location of the wound. In addition to septic processes, other reasons to gain access to the tendon sheath have been described for diagnostic intrathecal anesthesia, synovial fluid sampling, intrathecal contrast radiography, tenoscopy, through-and-through lavage, and therapeutic infusion of anti-inflammatory agents. 6,7,[13][14][15][16] Commonly, synoviocentesis is performed by penetration of the proximolateral pouch proximal to the palmar or plantar annular ligament and palmar or plantar to the lateral or medial suspensory branch. When prominent synovial fluid distention is present, this is a useful location for obtain...
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