Urethral Defects in Geldings With Hematuria and Stallions With Hemospermia

Abstract

A urethral defect, presumed to communicate with the corpus spongiosum penis, caused hematuria in seven geldings and hemospermia in three stallions. Hematuria in geldings occurred at the end of urination. Hematuria was not observed in stallions with hemospermia. A linear urethral defect was identified, by endoscopic examination, on the convex surface the urethra at the level of the ischial arch of each horse. Cause of the defect was not determined. Two stallions were successfully treated for hemospermia, one by temporary subischial urethrostomy combined with sexual rest for 10 weeks, and the other by sexual rest alone for 6 months. The third stallion had hemospermia 6 weeks after urethrostomy. The geldings were successfully treated for hematuria, six by temporary subischial urethrostomy, and one by a subischial incision that extended into the corpus spongiosum penis but did not enter the lumen of the urethra. Efficacy of subischial urethrostomy for treatment of hemospermia was difficult to assess because of the small number of surgically treated stallions. In geldings, surgery eliminated hematuria, presumably by reducing vascular pressure in the corpus spongiosum penis during urination, thus allowing the urethral defect to heal.

Buccal mucosal urethroplasty for treatment of recurrent hemospermia in a stallion

“…Successful treatment of a stallion with hemospermia by subischial urethrostomy was reported in 1995. 1 This surgical procedure, however, was unsuccessful in a second stallion in the same report. Further development of urethral surgical procedures for breeding stallions with urethral defects is warranted.…”

“…1 Hemorrhage into the urine or ejaculate occurs secondary to urethral defects as a result of the communication that develops between the urethral lumen and under- lying vascular corpus spongiosum. In geldings with urethral defects, hematuria is typically the complaint.…”

Diseases of the Equine Urinary System

“…29 Hematuria may be the result of numerous upper or lower urinary tract diseases, including glomerulonephritis, pyelonephritis, idiopathic hematuria, cantharidin toxicosis, and neoplasia, to name a few. 29,[33][34][35][36] Last, renal lipofuscin has been reported as an incidental finding in a horse with diffuse black pigmentation to the renal cortices. 37 McLeland Infectious causes of equine nephritis include viral, bacterial, and parasitic etiologies.…”

Surgical Correction of Abnormalities Affecting the Reproductive Organs of Stallions

“…43,[85][86][87][88] Hemospermia can also be caused by a urethral rent, the cause of which is unknown. 89 The usual source of voluminous hemorrhage is the CSP (Fig. 4-16).…”

“…Stallions affected with this form of hemospermia seem to be most effectively treated by temporary urethrotomy performed near the level of the ischial arch. 87,89,91 Urethrotomy is performed with the horse standing and sedated after administering epidural anesthesia. To facilitate identification of the urethra during dissection, a urethral catheter or the insertion tube of an endoscope is inserted into the urethra and advanced until it is proximal to the defect.…”