Complications, outcome and owner satisfaction after Callicrate Bander phallectomy and perineal urethrostomy in 14 equids

Abstract

Background: The use of a bander castration device (Callicrate Bander) to perform partial phallectomy in combination with a perineal urethrostomy (PU) has previously been described to be an effective and well-tolerated procedure in standing sedated horses. Objectives: The main objective of the present report is to share our experiences with the combined Callicrate Bander phallectomy (CBP) and PU (CBP/PU) focussing on potential complications, outcome and owner satisfaction. Study design: Retrospective case series. Methods: Medical records of 14 male equids that underwent CBP/PU at two different equine referral hospitals between 2012 and 2020 were reviewed. A long-term follow-up was conducted by telephone interview with the owners using a standardised questionnaire. Results: Equids underwent CBP/PU to treat penile and preputial squamous cell carcinomas (11/14), equine sarcoids (2/14) and penile abscessation and paraphimosis after trauma (1/14). Early post-operative complications were mild and included transient post-urination haemorrhage, perineal or preputial oedema and partial dehiscence of the PU. Complications that required further veterinary care in the immediate postoperative period occurred in one animal, which had haemorrhage at the amputation site with subsequent haematoma and oedema formation, causing moderate signs of post-operative pain. Complications encountered after discharge from the clinic comprised transient urine leakage at the amputation site, transient purulent preputial discharge, abscessation of the penile remnant and urine staining of the hind legs, tail and/or perineum. Four equids were euthanased because of tumour recurrence. Main limitations: Variable case details provided in the medical records, and information regarding the postoperative healing process were mainly based on owner assessment. Conclusions: CallicrateBander phallectomy/perineal urethrostomy is a well-tolerated salvage procedure for male equids with debilitating conditions of the penis and prepuce. Severe post-operative complications are rare. If advanced stages of penile SCC are expected, careful case selection based on a rigorous preoperative examination is mandatory. Owner satisfaction with the post-operative result is high. Clinical relevance• The combination of a Callicrate Bander phallectomy and perineal urethrostomy is well-tolerated in equids and allows for the removal of penile and preputial tissues up to the level of the external preputial orifice in the standing animal.• While transient mild post-operative complications at the amputation and perineal urethrostomy site are not infrequent, severe intra-and post-operative complications are rare.• Owner acceptance and satisfaction with the combined Callicrate Bander phallectomy and perineal urethrostomy procedure is high, but owners must be aware that urine staining of the hind legs and perineum is a frequent consequence of the perineal urethrostomy that may require daily cleaning to prevent urine scalding.