POST-CASTRATION COMPLICATIONS.
Complications after castration are conditionally divided into two groups: early and late.
Early complications are observed immediately after castration. These include: bleeding, prolapse of the omentum, intestines, bladder, common vaginal membrane and stump of the spermatic cord.
Late complications are detected a day or more after castration. These include: inflammation of the common vaginal membrane, inflammation of the stump spermatic cord, granulomas, abscesses, gangrene, peritonitis and sepsis.
Complications of the first group, as a rule, are not widespread, complications of the second group, especially in boars and rams, can be massive.
BLEEDING (HAEMATORRHOEA)
Bleeding can be from the artery and vein of the scrotum, the artery and vein of the spermatic cord, the artery of the testes, the artery of the vas deferens. The most dangerous bleeding from the vessels of the spermatic cord.
Etiology. The causes of bleeding can be: insufficient crushing of the tissues of the spermatic cord with castration forceps; sharp clamping of the spermatic cord with castration forceps, which causes not crushing, but a blunt intersection; technical malfunction of the tongs, which does not allow to clamp the tongs completely; weak clamping of the spermatic cord with a ligature, as a result of which the ligature may slip off; the so-called castration on the “separation” of the spermatic cord without control of the place of separation, as a result of which the spermatic artery sometimes comes off directly from the aorta; flabbiness of the tissues of the spermatic cord; vascular atherosclerosis in old males (boars and stallions); reduced blood clotting; sclerosis of the skin of the scrotum and varicose veins veins; unsanitary keeping of animals after castration.
Clinical signs. Bleeding can be primary or secondary. The primary manifests itself during the operation itself or several hours after its completion, and the secondary - several hours or even days after castration. Distinguish between external and internal bleeding.
From the arteries of the spermatic cord, blood flows most often in a small stream or a strong stream. The pressure of bleeding depends on the damage to the vessel. External bleeding and its type are determined when establishing and carefully examining the place of bleeding. A large blood loss is determined by the signs of acute anemia: pallor of the mucous membranes, increased respiration and pulse (poor filling), trembling of the animal, unsteady gait. When examining blood, a sharp decrease in the content of hemoglobin and erythrocytes is noted.
Internal bleeding is determined by increasing signs of acute anemia. The vessels of the scrotum bleed in drops, but for a long time, the blood is dark, venous.
Diagnosis. External bleeding is diagnosed by local signs, internal bleeding - by increasing signs of acute anemia, the content of red blood cells and hemoglobin is additionally determined. A sharp decline the latter indicates a significant loss of blood.
Treatment. The animal is given rest, plenty of cool water is given. Bleeding is stopped depending on the place of leakage: capillary bleeding from the scrotum - with tampons dipped in adrenaline; from the vessels of the spermatic cord - by applying a ligature to the extracted spermatic cord. Calcium chloride is administered intravenously. With a significant loss of blood, transfusion of blood substitutes is performed. To avoid complications of surgical infection, vikasol, antibiotics or sulfa drugs are prescribed.
EVENTRATION (LOSS) OF THE OIL (EVENTRATIO OMENTI)
Omental prolapse is most common in stallions with open castration. This complication can occur at any time during the operation or immediately after it. There are known cases of omentum falling out a few hours and days after castration. Omentum prolapse was observed in a stallion on the 11th day after the operation.
Etiology. Omental prolapse usually occurs with dilated inner rings of the vaginal (inguinal) canal. Perhaps it is with a strong tension of the abdominal press during the operation, especially if it is done without anesthesia, if the starvation diet is not followed before the operation or the fasting diet is too long.
Clinical signs. The part of the omentum that has fallen out can reach a considerable size and hangs down to the hocks. The dropped part of the omentum quickly becomes contaminated, infected and infringed in the vaginal canal. There are congestive hyperemia and swelling of the omentum. If the omentum fell into the cavity of the common vaginal membrane before castration, then the scrotum is enlarged in volume and testy to the touch.
When the omentum falls out, the animal does not show any pain reaction and stands calmly, although the part of the omentum that has fallen out can almost touch the ground. Temperature, pulse, respiration do not change.
Diagnosis. The diagnosis is based on clinical signs. It is necessary to differentiate the disease from prolapse of the intestines and bladder.
Forecast. With small deposits, the prognosis is favorable, with large ones with the presence of necrosis, it is cautious.
Treatment. If the omentum has fallen out after the operation, the animal is fixed in a standing position, a second fall should be avoided and resorted to only in extreme cases. Do surgical treatment of the fallen part of the omentum, isolate it with a sterile gauze napkin or towel. Then, in the absence of changes in the omentum, it is inserted into the vaginal cavity. If there is necrosis, then a ligature is applied to the healthy part, the underlying part of the omentum is cut off with scissors 0.5-2 cm below the ligature. Antibiotics are used to prevent the development of a surgical infection.
Intestinal prolapse is one of the most dangerous post-castration complications. Most often occurs in rabbits, boars and stallions.
Etiology. The causes of the disease are the same as with the prolapse of the omentum: improper fixation, i.e., strong compression of the abdominal press; public method castration with a wide internal inguinal ring; rupture of the muscles that form the inguinal canal.
Pathogenesis. The prolapsed intestine quickly dries up in the air and becomes contaminated. In addition, it is infringed in the vaginal canal. At the same time, the outflow of blood, the nutrition of the intestine are disturbed. Its color changes. Brown spots appear, which indicates necrosis of the intestinal wall. In addition, swelling and fissures of the intestine are observed.
Clinical signs. Loops of the small intestine usually fall out of one castration wound. Bilateral prolapse is a rare case. Most often, the intestine falls out during castration, less often after it. A case of intestinal prolapse in a stallion on the 5th day after castration is described.
In stallions, the intestinal loop hangs down to the hocks and even to the ground. Boars often have eventration of a large part of the intestine in the form of short loops that form a whole ball.
In the external environment, the intestine is irritated, and the animal reflexively reacts to it as to a foreign body. As a result, muscles abdominals are sharply reduced. Stallions get colic. If more than 6 hours pass after the fallout, then the stallions may develop peritonitis, the body temperature rises, the pulse and respiration become more frequent. The animal is oppressed.
Diagnosis. The disease is diagnosed on the basis of a clinical examination. Differentiate from prolapse of the bladder, omentum.
Treatment. Protect the prolapsed part of the intestine from drying out and contamination. To do this, use a sterile sheet and napkins, watered with warm saline. The operation is performed under anesthesia. The animal is fixed in a supine position. After examination and treatment, the intestines are set. To do this, straighten the common vaginal membrane and fix it by the edges of the wound. A finger is inserted between the intestines and the canal wall and the degree of intestinal infringement is determined. If there is no infringement, the prolapsed part of the intestine is set with the index finger, starting from the part of the intestine that is in contact with the wall of the vaginal canal. Gradually, slowly, they push the intestine in small parts. In the presence of gases, a puncture is made with a thin injection needle at an angle of 45 °. When the intestine is infringed in the vaginal canal, under the control of the index finger, the outer ring is cut by 2-4 cm with a bell-shaped scalpel. The wall of the canal should not be cut forward and inward, so as not to damage the posterior hypogastric artery. After dissection, the intestines are adjusted, and then 2-4 knotted sutures are applied. If the intestinal wall is damaged, sutures are applied, necrotic sections of the intestine are excised. After the operation, the animal is prescribed rest, good dietary feeding, water is given in small portions. To reduce thirst, an isotonic sodium chloride solution and a 30% glucose solution are administered intravenously to the animal - 300-400 ml each. PROLAPSUS TUNICAE VAGINALIS COMMUNIS
The prolapse of the common vaginal membrane is more often observed in stallions and, as a rule, after inept castration in camels:
Etiology. The causes of the disease can be a large detachment of the common vaginal membrane, adhesions of the testis own membrane with the common vaginal membrane, sclerotic changes in the membrane itself in old boars.
Pathogenesis. The fallen part of the common vaginal membrane becomes contaminated, infected, and inflammation of the common vaginal membrane develops.
Clinical signs. After castration of the animal, especially when the animal is standing, a common vaginal membrane hangs from the castration wound on one side or on both sides in the form of rollers. The edges of the skin are swollen. The general condition of the animal does not change. If it develops purulent inflammation, the general condition also changes: the body temperature rises, the pulse and respiration become more frequent.
Diagnosis. They put it when examining a wound.
Forecast. In the initial stage of the disease, the prognosis is favorable, in advanced cases - cautious, since complications are possible.
Treatment. Operational. The fallen out shell is excised before its exfoliation, the blood is stopped and antiseptics are used to avoid complications with a purulent infection.
PROLAPSUS FUNICULI SPERMATIEI STUNT
The prolapse of the stump of the spermatic cord is more often observed in stallions, camels, less often in animals of other species.
Etiology. Stump prolapse is possible with excessive tension of the spermatic cord, too low or high incisions of the scrotum, tears of the muscles of the testis lifters, separation of the testes in the area of the vascular cone.
Pathogenesis. The fallen part of the spermatic cord becomes contaminated and exposed to physical environmental factors. There is inflammation of the spermatic cord, which can go to the common vaginal membrane and peritoneum. Often, a granuloma develops as a result of irritation.
Clinical signs. Depending on the cause, the fallout can occur immediately after surgery or after 2-3 days. The hanging part of the stump is visible from the castration wound. In advanced cases, inflammation or complications with various fungi, such as botryomycoma, are possible.
Diagnosis. They put it when examining the wound: the hanging spermatic cord is clearly visible.
Treatment. In all cases, observing all the rules of asepsis, cut off the fallen part of the stump of the spermatic cord within healthy tissue and apply a ligature (in horses - only catgut, otherwise there may be complications).
PROLAPSUS VESICAE URINARIAE
The disease can occur in animals of all species, but is more common in stallions and boars.
Etiology. It usually happens with a wide internal inguinal ring and canal, rupture of the internal inguinal ring, hernia, rickets.
Clinical signs. The bladder exits into the vaginal or inguinal canal. When prolapsed into the vaginal canal, a swelling is found along the latter. When pressing on this swelling, urination occurs, and its size decreases somewhat. When examining a castration wound, a bladder is found in the form of a ball covered with fibrin films.
When dropped Bladder in the inguinal canal, a swelling is found next to the scrotum in the region of the external opening of the canal. It slowly increases as the bladder fills. When pressing on the swelling, urine is released. In case of rupture of the bladder, peritonitis develops after a while. In this case, there is no swelling, the tissues are saturated with urine.
Diagnosis. They put it in the study of a castration wound on clinical grounds.
Forecast. In recent cases, if there is no rupture of the bladder, the prognosis is favorable, in other cases - unfavorable.
Treatment. After clarifying the diagnosis, surgical treatment of the wound and the bladder is performed, freeing from urine. By clicking on it, they are set into the abdominal cavity. The vaginal canal is closed with a vaginal membrane, as in the closed castration method.
In advanced cases, an incision is made over the inguinal ring, as in hernia repair. With a strong filling of the bladder, urine is removed by pressing on it, or by puncture, then the bladder is set into the abdominal cavity. The ring is closed, as in hernia repair. When the bladder is ruptured, intestinal sutures are placed. Monitor the general condition of the animal.
Post-castration edema (OEDEMA POSTCASTRATIONEM)
After castration, an inflammatory edema develops as a reaction of the body to injury. This most frequent complication is sometimes massive.
Etiology. Inflammatory edema can be in violation of asepsis and antisepsis; castration of dirty, unprepared animals; post-castration infection of wounds, when rooms for castrated animals are dirty; with careless castration, when a lot of blood remains in the wound; with small incisions, stratification of tissues. Contribute to the development of edema castration of sick animals, allergic disorders, loose constitution, non-compliance with post-castration care for animals, lack of walks, hypoavitaminosis, prolonged castration.
Pathogenesis. In stallions, the initial reaction is always manifested by the development of serous or serous-fibrinous inflammation, which turns into serous-purulent after 3-4 days. The inflammatory process develops where more dead tissue, clotted blood, and then goes to other areas, capturing the loose tissue of the inguinal canal, and phlegmon develops. In horses, as a rule, gram-positive monoinfection, rarely associations.
In male artiodactyls, the complication of wounds mainly occurs with gram-positive and gram-negative polyinfection, there may be a combination of aerobes with anaerobes. The presence of blood and dead tissue in the wound contributes to the development of infection. The initial reaction in artiodactyls is manifested by fibrinous inflammation, which turns into purulent after 8-20 days. In connection with the loss of fibrin and the closure of the wound, conditions are created for the development of anaerobic phlegmon or abscess. AT severe cases possible gangrene of the scrotum or sepsis.
Clinical signs. As a rule, inflammatory edema after castration is a normal reaction of the body. If the scrotum increases by 1.5-2 times or more, the inflammatory edema spreads to the prepuce and even to the abdomen, a high neutrophilic leukocytosis appears, this indicates a complication of infection. If the body temperature rises by 1 - 1.5 "C, when rendering medical care after 10-12 days, all indicators of the body are normalized. At a temperature of 40 ° C and above, increased heart rate and respiration, depression, refusal to feed, phlegmon develops. Serous or serous-fibrinous exudate is first released from the wound, then purulent.
In boars, four forms of complications are distinguished, accompanied by edema against the background of major diseases: phlegmon, vaginitis, vaginalito-phoniculitis and peritonitis. Here are all the clinical signs inherent in these diseases.
In bulls and sheep, inflammatory edema develops against the background of anaerobic phlegmon. If you do not provide assistance, the animals die from anaerobic sepsis.
Diagnosis. The disease is diagnosed on the basis of clinical signs; the type of microorganisms is determined by bacteriological research. However, inflammatory edema should be differentiated from congestive edema. Congestive edema is always cold, painless, when pressed with a finger, the fossa is slowly filled. Inflammatory edema has all the signs of inflammation.
Forecast. AT initial stages with active complex treatment, the prognosis is favorable, in advanced cases - cautious or unfavorable, peritonitis and sepsis may develop.
Treatment. In inflammatory edema, treatment should be
urgent and complex. At general treatment prescribe a course of antibiotics. In these cases, subtitration is done and the most sensitive antibiotic to the microflora under study is established.
Without titration, horses are most indicated for antibiotics of the penicillin series, better prolonged bicillin-3 or bicillin-5; for boars, bulls, rams - a combination of penicillin and streptomycin equally. Doses of antibiotics - 15-20 thousand units per 1 kg of animal weight. Intravenously prescribed glucose, calcium chloride, camphor serum according to Kadykov's prescription. In order to desensitize the body, novocaine is administered intravenously. At high temperature intravenous injections should be done very slowly, better by drip. Spend local treatment, surgical treatment of the wound, purulent exudate lingering between adhesions is removed. When body temperature drops to normal, heat is applied, light massage, dosed wiring, starting with 10 minutes and gradually increasing to 30-40 minutes 2 times a day.
INFLAMMATORY OF THE COMMON VAGINA (VAGINALITIS)
The disease is more common in stallions, boars and rams.
Etiology. The reasons may be: detachment of the common vaginal membrane during surgery; large infiltration with novocaine solution during anesthesia; too low and high cuts; accumulation of clotted blood; contamination of the cavity of the common vaginal membrane; transition inflammatory process on the common vaginal membrane along the continuation from the stump of the spermatic cord; bruises of the testes with the formation of connective tissue adhesions; burns of the common vaginal membrane alcohol solution iodine during castration.
Pathogenesis. After removal of the testicles, the common vaginal membrane is often pulled upward due to a strong contraction of the external cremaster. If the incisions were of insufficient length, then there is a adhesion of the sheets of the common vaginal membrane stretched upward due to serous-fibrinous or fibrinous inflammation along the line of its incision. This leads to the formation of a cavity between the sheets, separated from the cavity of the wound of the scrotum. The so-called " hourglass» (Fig. 36). Exudate accumulates in this cavity, which compresses the tissues, causing a strong pain reaction. With aseptic inflammation, the exudate is resorbed, but if the process is complicated by microflora, then purulent inflammation develops. The absorption of decay products from a closed purulent cavity is accompanied by an acute reaction of the body.
In boars, the "hourglass" is formed at small, low
Fascia sub-dartoici
T. vagina/is communis
stump seed
~ foot canateak
inflame, exudate
incisions of the scrotum. At the site of the incision, a gray scab is formed, the shell itself sprouts with connective tissue and significantly increases in volume.
Rice. 36. Formation of a wound in the form of an "hourglass" (B. M. Olivkov)
In bulls, fibrinous inflammation of the membrane is also observed, only with a more pronounced connective tissue reaction.
Clinical signs. In stallions in the first 5 days and later, after castration, when the wound is already granulating, diffuse edema may develop rapidly. In this case, the body temperature rises to 39.5-40 "C, the general condition of the animal worsens sharply, neutrophilic leukocytosis is observed. Locally, unilateral or bilateral hot, painful swelling of the scrotum is noted. With the formation of an "hourglass", the exudate discharge is insignificant, on palpation in the upper part of the scrotum fluctuation is detected.When the commissure of the hourglass shell breaks, exudate is immediately released in large quantities.It is liquid, yellow color, with fibrin. After removing the exudate general reaction body improves immediately.
In boars, the disease is also severe. The swelling is painful, has a spherical shape. From the castration wound, exudate of a putrid odor is released in a small amount.
Forecast. In recent cases, the prognosis is favorable, in advanced cases - cautious or unfavorable.
Treatment. It is necessary to make mechanical antiseptics and toilet wounds with a 3% hydrogen peroxide solution. If an hourglass has formed, adhesions are eliminated and exudate and dead tissue are removed. At elevated temperature prescribed antibiotic therapy.
Inflammation of the stump of the spermatic cord (FUNICULITIS)
Inflammation of the spermatic cord is more common in stallions, boars and sheep.
Etiology. The main causes of funiculitis: infection of the stump of the spermatic cord during surgery, when the rules of asepsis and antisepsis are violated; prolapse of the stump from the wound;
a large area of crushing of the stump; the imposition of a ligature or forceps in the area of the vascular cone; the imposition of a rough ligature, difficult to encapsulate or resorb; the formation of hematomas in the vascular cord; leaving significant curls at the end of the stump when unscrewing the spermatic cord; complication of botryomycosis and actinomycosis fungi. Reduced body resistance to infections, traumatic shock, etc. predispose to inflammation of the spermatic cord.
Pathogenesis. After the removal of the testicles, aseptic inflammation develops as a reaction to mechanical injury. If the inflammatory process is not complicated by a surgical infection, this is where it ends. When the stump of the spermatic cord becomes infected, the body's reaction to the infection develops. At timely treatment a demarcation shaft may form and the dead stump will move away with exudate. However, with a weak demarcation shaft, the infection spreads along the continuation, forming blood clots, necrosis, abscesses.
In severe cases pathological process spreads along the cord and the vaginal canal, and peritonitis, purulent fistulas with the release of purulent exudate are possible. The process may end in sepsis.
In horses, the inflammatory process can be complicated by botryomycosis, and in artiodactyls by actinomycosis; possible granuloma of the spermatic cord.
Clinical signs. The first symptoms of the disease are pain, pronounced on palpation, and an increase in the size of the spermatic cord. The swelling can be unilateral or bilateral. Acute inflammation appears on the 3-5th day after castration. Changes general state animal: it is oppressed, completely or partially refuses to feed; body temperature rises, neutrophilic leukocytosis increases. The movement of the animal is difficult with abduction of the pelvic limb. In horses, after 3-4 days, abscesses form along the spermatic cord, then fistulas and ulcers, the cord becomes dense and immobile. Peritonitis may develop.
Diagnosis. The disease is diagnosed by clinical signs.
Forecast. In recent cases, favorable, in neglected cases, there may be various complications: peritonitis, sepsis, metastatic pneumonia.
Treatment. Carry out mechanical and chemical antiseptics. In fresh cases, a stump of the spermatic cord is found, it is tied up in a healthy part and the inflamed part is cut off. In advanced chronic cases, all dead tissue and the stump of the spermatic cord are removed, or incisions are made in the groin area and all dead tissue is removed. The cavities are washed with a 3% hydrogen peroxide solution, Vishnevsky's emulsion is used, etc. General antibiotic therapy and symptomatic treatment are prescribed.
GRANULOMA FUNICULI SPERMATICIS
An inflammatory granuloma is a tumor built according to the type of granulation tissue. Mostly geldings are affected, but males of other species can also be affected.
Granulomas of the spermatic cord can be nonspecific and specific, or infectious, observed when complicated by actinomycosis or botryomycosis.
Etiology. The granuloma of the spermatic cord can be the result of irritation with a poor-quality coarse ligature, the application of a ligature or forceps in the area of the vascular cone, cauterization of the stump of the spermatic cord with an alcoholic solution of iodine or other irritants. chemicals, incomplete removal of appendages, hit on the stump foreign objects, damage to the stump of the cord by actinomycosis or botryomycosis.
Pathogenesis. Nonspecific granulomas develop as a result of irritation of the tissues of the cord. The body responds to any prolonged irritation with an inflammatory reaction and increased growth granulation tissue. In cases where the irritant is not fixed in the tissues, it is usually exuded into the external environment by exudation, and recovery occurs. If the irritant is fixed in the tissues, for example, a poor-quality ligature in horses, then the inflammation continues and is accompanied by increased growth of granulation tissue and the formation of a granuloma, which can reach large sizes. In the future, fibrinous degeneration of the granuloma occurs and it itself becomes an irritant and supports the course of the reactive process in the form of purulent or fibrinous inflammation.
There may be a complication of the spermatic cord with actinomycosis or botryomycosis. Fungal granulomas grow slowly and can be of various sizes.
Clinical signs. Specific granulomas are much less common; botryomycosis, as a rule, in horses, actinomycosis in artiodactyls. More often, nonspecific granulomas of the spermatic cord are recorded in males of all species. They are mushroom-shaped or spherical in shape, different sizes. In some cases, the granuloma grows, pulls the spermatic cord and falls out of the wound of the scrotum. Its surface is dark red, covered with exudate, crusts and fibrin. With a complication of infection, body temperature may increase.
With actinomycosis granuloma, abscesses and purulent fistulas form on the surface. Purulent exudate thick white color. Microscopy establishes botryomycotic drusen. Granulomas are tuberous, fused with surrounding tissues; there may also be abscesses and purulent fistulas on the surface. In either case, the process can take years.
Diagnosis. The disease is diagnosed by clinical signs. Exclude actinomycosis or botryomycosis granuloma or tumor by biopsy, microscopic or bacteriological examination.
Spermatozoal granuloma occurs mainly before 30 years of age. The epididymis of the right testicle (its head and body) is more often affected, in about 14% of patients - both epididymis. Most often, spermatozoal granuloma occurs as a result of a previous inflammatory process in the ducts of the epididymis, after damage to the vas deferens or as a complication after resection of the spermatic cord, plastic surgery taken to restore the patency of the vas deferens in obstructive azoospermia (see full body of knowledge). Inflammatory changes in the epididymis of a specific or non-specific etiology are usually the main condition predisposing to the development of Spermatozoal granuloma Approximately 50% of patients simultaneously with Spermatozoal granuloma in the epididymis show a tuberculous process, in 30% - nonspecific epididymitis (see full body of knowledge). Due to cicatricial narrowing of the ducts of the epididymis, their patency is disturbed, stasis of the contents occurs, and then focal destruction of the epithelial cover and basement membrane of the ducts, which contributes to the penetration of spermatozoa into the surrounding interstitial tissue. It is also possible to develop spermatozoal granuloma due to an aseptic inflammatory process. In the tissue of the testis, spermatozoal granuloma occurs with the so-called granulomatous orchitis (see full body of knowledge).
Morphologically, three stages of development are distinguished. Spermatozoal granuloma In the first stage, spermatozoa and seminal fluid penetrate from the ducts of the epididymis into its tissue. In the second stage, a granulomatous reaction occurs in the epididymal tissue around the spermatozoa and seminal fluid that have penetrated into it, which is expressed in the accumulation of leukocytes, epithelioid, plasma and giant cells, as well as macrophages that phagocytize spermatozoa. The maturing granulation tissue (see full body of knowledge) is enriched with collagen fibers. In the third stage, scarring of the granuloma occurs, while along its periphery there is lymphoid infiltration and fibrosis, the severity of which depends on the duration of the process.
The affected epididymis on the section is white-gray with yellow-brown foci, along the periphery the consistency of the epididymis is softer than in the center. The sick are worried aching pain in the scrotum, aggravated by walking and ejaculation. The epididymis, rarely the testicle itself, gradually increase. Palpation reveals a dense, painless infiltrate ranging in size from 3-5 millimeters to 7 centimeters. In 1/3 of patients, the appendage becomes tuberous. At the same time, the spermatic cord is compacted or clearly changed. Most patients have signs of tuberculous or nonspecific epididymitis.
The diagnosis is established by histological examination of the material obtained by biopsy.
Differential diagnosis is carried out with tuberculous and nonspecific epididymitis (see the full body of knowledge), malacoplakia (see the full body of knowledge), neoplasms of the epididymis and the testicle itself (see the full body of knowledge).
Treatment is mainly surgical: epididymectomy is performed (excision of the epididymis). With spermatozoal granuloma of the testicle, according to indications, resection or removal of the testicle is carried out. With spermatozoal granuloma of the vas deferens, resection of the affected area of the duct is necessary with end-to-end anastomosis.
The prognosis for reproductive and sexual functions with a unilateral lesion is favorable.
After castration, an inflammatory edema develops as a reaction of the body to injury. This is the most common complication sometimes it's massive.
Etiology. Inflammatory edema can be in violation of asepsis and antisepsis; castration of dirty, unprepared animals; post-castration infection of wounds, when rooms for castrated animals are dirty; with careless castration, when a lot of blood remains in the wound; with small incisions, stratification of tissues. Contribute to the development of edema castration of sick animals, allergic disorders, loose constitution, non-compliance with post-castration care for animals, lack of walks, hypoavitaminosis, prolonged castration.
Pathogenesis. In stallions, the initial reaction is always manifested by the development of serous or serous-fibrinous inflammation, which turns into serous-purulent after 3-4 days. The inflammatory process develops where there is more dead tissue, clotted blood, and then goes to other areas, capturing the loose tissue of the inguinal canal, and phlegmon develops. In horses, as a rule, gram-positive monoinfection, rarely associations.
In male artiodactyls, the complication of wounds mainly occurs with gram-positive and gram-negative polyinfection, there may be a combination of aerobes with anaerobes. The presence of blood and dead tissue in the wound contributes to the development of infection. The initial reaction in artiodactyls is manifested by fibrinous inflammation, which turns into purulent after 8-20 days. In connection with the loss of fibrin and the closure of the wound, conditions are created for the development of anaerobic phlegmon or abscess. In severe cases, gangrene of the scrotum or sepsis is possible.
Clinical signs. As a rule, inflammatory edema after castration is a normal reaction of the body. If the scrotum increases by 1.5-2 times or more, the inflammatory edema spreads to the prepuce and even to the abdomen, a high neutrophilic leukocytosis appears, this indicates a complication of infection. If the body temperature rises by 1 - 1.5 ° C, when providing medical assistance, after 10-12 days, all indicators of the body are normalized. At a temperature of 40 ° C and above, increased heart rate and respiration, depression, refusal to feed, phlegmon develops. A serous or serous-fibrinous exudate is first released from the wound, then purulent.
In boars, four forms of complications are distinguished, accompanied by edema against the background of major diseases: phlegmon, vaginitis, vaginalito-phoniculitis and peritonitis. Here are all the clinical signs inherent in these diseases.
In bulls and sheep, inflammatory edema develops against the background of anaerobic phlegmon. If you do not provide assistance, the animals die from anaerobic sepsis.
Diagnosis. The disease is diagnosed on the basis of clinical signs; the type of microorganisms is determined by bacteriological research. However, inflammatory edema should be differentiated from congestive edema. Congestive edema is always cold, painless, when pressed with a finger, the fossa is slowly filled. Inflammatory edema has all the signs of inflammation.
Forecast. In the initial stages with active complex treatment the prognosis is favorable, in advanced cases - cautious or unfavorable, peritonitis and sepsis may develop.
Treatment. In inflammatory edema, treatment should be
urgent and complex. With general treatment, a course of antibiotics is prescribed. In these cases, subtitration is done and the most sensitive antibiotic to the microflora under study is established.
Untitrated horses are most indicated for antibiotics penicillin series, better prolonged bicillin-3 or bicillin-5; for boars, bulls, rams - a combination of penicillin and streptomycin equally. Doses of antibiotics - 15-20 thousand units per 1 kg of animal weight. Intravenously prescribed glucose, calcium chloride, camphor serum according to Kadykov's prescription. In order to desensitize the body, novocaine is administered intravenously. At high temperatures, intravenous injections should be done very slowly, preferably by drip. Local treatment is carried out, surgical treatment of the wound, purulent exudate lingering between adhesions is removed. When the body temperature drops to normal, apply heat, light massage, dosed wiring, starting from 10 minutes and gradually increasing to 30-40 minutes 2 times a day.
INFLAMMATORY OF THE COMMON VAGINA(VAGINALIT I S)
The disease is more common in stallions, boars and rams.
Etiology. The reasons may be: detachment of the common vaginal membrane during surgery; large infiltration with novocaine solution during anesthesia; too low and high cuts; accumulation of clotted blood; contamination of the cavity of the common vaginal membrane; the transition of the inflammatory process to the common vaginal membrane along the continuation from the stump of the spermatic cord; bruises of the testes with the formation of connective tissue adhesions; burns of the common vaginal membrane with an alcohol solution of iodine during castration.
Pathogenesis. After removal of the testicles, the common vaginal membrane is often pulled upward due to a strong contraction of the external cremaster. If the incisions were of insufficient length, then there is a adhesion of the sheets of the common vaginal membrane stretched upward due to serous-fibrinous or fibrinous inflammation along the line of its incision. This leads to the formation of a cavity between the sheets, separated from the cavity of the wound of the scrotum. The so-called "hourglass" is formed (Fig. 36). Exudate accumulates in this cavity, which compresses the tissues, causing a strong pain reaction. With aseptic inflammation, the exudate is resorbed, but if the process is complicated by microflora, then purulent inflammation develops. The absorption of decay products from a closed purulent cavity is accompanied by an acute reaction of the body.
In boars, the hourglass is formed by small, low incisions in the scrotum. At the site of the incision, a gray scab is formed, the shell itself sprouts with connective tissue and significantly increases in volume.
In bulls, fibrinous inflammation of the membrane is also observed, ONLY with a more pronounced connective tissue reaction.
Clinical signs. In stallions in the first 5 days and later, after castration, when the wound is already granulating, diffuse edema may develop rapidly. In this case, the body temperature rises to 39.5-40 ° C, the general condition of the animal worsens sharply, neutrophilic leukocytosis is observed. Locally, unilateral or bilateral hot painful swelling of the scrotum is noted. With the formation of an "hourglass", the release of exudate is insignificant, fluctuation is detected on palpation in the upper part of the scrotum. When the commissure of the "hourglass" shell breaks, immediately in in large numbers exudate is released. It is liquid, yellow in color, with fibrin. After removing the exudate, the overall reaction of the body immediately improves.
In boars, the disease is also severe. The swelling is painful, has a spherical shape. From the castration wound, exudate of a putrid odor is released in a small amount.
Diagnosis.
Forecast. AT fresh cases, the prognosis is favorable, in advanced cases - cautious or unfavorable.
Treatment. It is necessary to make mechanical antiseptics and toilet wounds with a 3% hydrogen peroxide solution. If an hourglass has formed, adhesions are eliminated and exudate and dead tissue are removed. At elevated temperatures, antibiotic therapy is prescribed.
Inflammation of the stump of the spermatic cord (FUNICULITIS)
Inflammation of the spermatic cord is more common in stallions, boars and sheep.
Etiology. The main causes of funiculitis: infection of the stump of the spermatic cord during surgery, when the rules of asepsis and antisepsis are violated; prolapse of the stump from the wound;
a large area of crushing of the stump; the imposition of a ligature or forceps in the area of the vascular cone; the imposition of a rough ligature, difficult to encapsulate or resorb; the formation of hematomas in the vascular cord; leaving significant curls at the end of the stump when unscrewing the spermatic cord; complication of botryomycosis and actinomycosis fungi. Reduced body resistance to infections predispose to inflammation of the spermatic cord, traumatic shock and etc.
Pathogenesis. After the removal of the testicles, aseptic inflammation develops as a reaction to mechanical trauma. If the inflammatory process is not complicated by a surgical infection, this is where it ends. When the stump of the spermatic cord becomes infected, the body's reaction to the infection develops. With timely treatment, a demarcation shaft may form and the dead stump will move away with exudate. However, with a weak demarcation shaft, the infection spreads along the continuation, forming blood clots, necrosis, abscesses.
In severe cases, the pathological process spreads along the cord and the vaginal canal, and peritonitis, purulent fistulas with the release of purulent exudate are possible. The process may end in sepsis.
In horses, the inflammatory process can be complicated by botryomycosis, and in artiodactyls by actinomycosis; possible granuloma of the spermatic cord.
Clinical signs. The first symptoms of the disease are pain, pronounced on palpation, and an increase in the size of the spermatic cord. The swelling can be unilateral or bilateral. Acute inflammation appears on the 3-5th day after castration. The general condition of the animal changes: it is depressed, completely or partially refuses to feed; body temperature rises, neutrophilic leukocytosis increases. The movement of the animal is difficult with abduction of the pelvic limb. In horses, after 3-4 days, abscesses form along the spermatic cord, then fistulas and ulcers, the cord becomes dense and immobile. Peritonitis may develop.
Diagnosis. The disease is diagnosed by clinical signs.
Forecast. AT fresh cases are favorable, in advanced cases there may be various complications: peritonitis, sepsis, metastatic pneumonia.
Treatment. Carry out mechanical and chemical antiseptics. In fresh cases, a stump of the spermatic cord is found, it is tied up in a healthy part and the inflamed part is cut off. In advanced chronic cases, all dead tissue and the stump of the spermatic cord are removed, or incisions are made in the groin area and all dead tissue is removed. The cavities are washed with a 3% hydrogen peroxide solution, Vishnevsky's emulsion is used, etc. General antibiotic therapy and symptomatic treatment are prescribed.
GRANULOMA FUNICULI SPERM AT ICIS)
An inflammatory granuloma is a tumor built according to the type of granulation tissue. Mostly geldings are affected, but males of other species can also be affected.
Granulomas of the spermatic cord can be nonspecific and specific, or infectious, observed when complicated by actinomycosis or botryomycosis.
Etiology. A granuloma of the spermatic cord can be the result of irritation with a poor-quality coarse ligature, the application of a ligature or forceps in the area of the vascular cone, cauterization of the stump of the spermatic cord with an alcoholic solution of iodine or other irritating chemicals, incomplete removal of appendages, foreign objects on the stump, damage to the stump of the funiculus by actinomycosis or botryomycosis.
Pathogenesis. Nonspecific granulomas develop as a result of irritation of the tissues of the cord. The body responds to any prolonged irritation inflammatory reaction and increased growth of granulation tissue. In cases where the irritant is not fixed in the tissues, it is, as a rule, excreted by exudation into external environment and recovery is coming. If the irritant is fixed in the tissues, for example, a poor-quality ligature in horses, then the inflammation continues and is accompanied by increased growth of granulation tissue and the formation of a granuloma, which can reach a large size. In the future, fibrinous degeneration of the granuloma occurs and it itself becomes an irritant and supports the course of the reactive process in the form of purulent or fibrinous inflammation.
There may be a complication of the spermatic cord with actinomycosis or botryomycosis. Fungal granulomas grow slowly and can be of various sizes.
Clinical signs. Specific granulomas are much less common; botryomycosis, as a rule, in horses, actinomycosis in artiodactyls. More often, nonspecific granulomas of the spermatic cord are recorded in males of all species. They are mushroom-shaped or spherical in shape, of different sizes. In some cases, the granuloma grows, pulls the spermatic cord and falls out of the wound of the scrotum. Its surface is dark red, covered with exudate, crusts and fibrin. With a complication of infection, body temperature may increase.
With actinomycosis granuloma, abscesses and purulent fistulas form on the surface. Purulent exudate is thick, white. Microscopy establishes botryomycotic drusen. Granulomas are tuberous, fused with surrounding tissues; there may also be abscesses and purulent fistulas on the surface. In either case, the process can take years.
Diagnosis. The disease is diagnosed by clinical signs. Exclude actinomycosis or botryomycosis granuloma or tumor by biopsy, microscopic or bacteriological examination.
Forecast. With nonspecific granulomas, the prognosis is favorable, with specific ones in fresh cases - favorable, in advanced cases - cautious or unfavorable.
Treatment. All granulomas of the spermatic cord are removed surgically by the type of open castration. If the granulomatous process spreads to the surrounding tissues, these tissues must be removed as far as possible. Prescribe antibiotic therapy and monitor the general condition of the body.
RETROPERITONEAL ABSCESS (ABSCESSUS RE T ROPER I TON I AL I S)
it rare complication occurs in geldings and develops regardless of the method of castration.
Etiology. The disease develops with minor post-castration complications as a result of funiculitis and vanillitis. This is a secondary infection that spreads through the lymphatic vessels of the scrotum into the subperitoneal tissue. Abscesses form under the parietal peritoneum, in the area of the internal inguinal ring, in the retroperitoneal pelvic tissue, bladder wall, rectum and colon.
Clinical signs. 3-4 weeks after castration, the first signs of the disease appear: the body temperature rises, the pulse and respiration become more frequent, the gait is tense, painful, there is no appetite, the general condition is depressed. abdominal wall tense. If an abscess develops in the pelvis (in the region of the bladder, in the retroperitoneal pelvic tissue), then difficulty urinating and defecation pain appear.
Diagnosis. The disease is diagnosed by clinical signs, clarified by rectal examination.
Forecast. With retroperitoneal abscesses, the prognosis is doubtful, often unfavorable.
Treatment. Appoint course treatment antibiotics in doses of 15-20 thousand units per 1 kg of animal weight. For this purpose, antibiotics are titrated to the identified microflora. It is recommended to apply ultraviolet irradiation blood. When the abscess is localized in the region of the internal inguinal ring, an operation is performed like a hernia repair and the abscess is removed. Carry out symptomatic therapy.
FEATURES OF POST-CASTRATION COMPLICATIONS IN RAMS
A post-castration complication in sheep is often manifested by massive anaerobic phlegmons. This is due to the reactivity of the sheep organism and the anatomical position of the scrotum. In rams, the testicles are long-necked and hang down to the hock. When the animal lies down, the scrotum falls on the floor or soil.
Etiology. Anaerobic phlegmon in sheep as a complication after castration is most often caused by clostridium (C1. reg-fringens, CI. oedematiens, Vibrion septique), sometimes by associations of clostridium and putrefactive microbes (B. colicommunis, B. subtilis, B. proteus vulgaris). Infection can occur during castration, when the rules of asepsis and antisepsis are violated, as well as when sheep are kept after castration in unsanitaryly prepared places.
Contribute to the development of anaerobic phlegmon small incisions of the scrotum, stratification of its walls, accumulated blood clots in the cavity of the scrotum, pasture of animals after castration, exposure of animals to rain.
Pathogenesis. The body of sheep reacts to injury by rapid loss of fibrin and the formation of adhesions, which creates anaerobic conditions in the wound. The presence of blood clots in it is favorable for the development anaerobic infection. After 1-3 days, in this case, anaerobic phlegmon of the scrotum develops. The infection quickly spreads through the loose tissue of the scrotum, inguinal canal and fascia of the thigh. Fibrinous inflammation and tissue edema, vascular thrombosis, tissue necrosis develop. Severe intoxication sets in. Without treatment, the animal dies from anaerobic sepsis.
Clinical signs. 1-3 days after castration, a significant swelling of the scrotum appears with the capture of the prepuce, abdomen and thighs. A liquid bloody exudate with a putrid odor is released from the wound, sometimes with an admixture of gas bubbles of anaerobic phlegmon. The animal is oppressed, refuses to feed, lowers its head and lies more. Body temperature 40 ° C or more. Blood tests show leukocytosis. Without emergency assistance the animal dies in 2-4 days.
Diagnosis. The disease is diagnosed on the basis of clinical signs, the type of microbe is specified by bacteriological examination.
Forecast. In fresh cases with active therapy, the prognosis may be favorable, in protracted cases, when edema increases, it is often unfavorable.
Treatment. Sick rams are isolated in separate group and immediately begin treatment. Until the type of anaerobe and the sensitivity of the microbe to antibiotics are clarified, antibiotics are used a wide range actions. Their doses should be more than 15-20 thousand units per 1 kg of animal weight. Wounds are opened, blood clots, dead tissue, fibrin are removed, washed abundantly with a 3% hydrogen peroxide solution or potassium permanganate solution. A circular novocaine block with antibiotics is carried out on the border with edema. It is recommended to introduce oxygen into the swollen part of the scrotum and at the border of healthy tissue. Assign symptomatic therapy.
PREVENTION OF POST-CASTRATION COMPLICATIONS
The main task of veterinarians is the prevention of post-castration complications. There are general and private, or individual, prevention of complications. To general prevention includes the preparation of premises and machines, animals. Private, or individual, prevention involves the study of the animal before castration for right choice operation method. Only clinically healthy animals with normal body temperature and no inflammatory processes are selected for castration. In the presence of acute infectious diseases in the economy, castration is not carried out until they are eliminated. In each animal, the inguinal rings are checked by external examination and palpation, in stallions they resort to rectal examination.
During the operation, it is necessary to observe maximum asepsis and antisepsis, it is not recommended to treat wounds with an alcohol solution of iodine. Getting on the common vaginal membrane, the iodine solution causes severe pain irritation, especially in boars, which sit on the ground or floor and contaminate the wounds with manure or earth.
Animals are prepared for surgery by prescribing a starvation diet, the operation site is cleaned, and those that are too dirty are washed.
For the castration of animals organize jobs. In a day or two, the machines are cleaned of manure, disinfected, bleached. Animals are provided with dry, mold-free bedding. After castration, animals are kept in prepared pens for 5-6 days until a scab forms on wounds in artiodactyls and granulation tissue in horses. Under no pretext should animals be released to pasture immediately after castration. Changes in the weather and exposure of animals to rain lead to massive complications, especially in rams and boars. Stallions after castration must be prescribed walks, starting from 10 minutes and bringing up to 1 hour 2 times a day.
In order to prevent postoperative purulent-inflammatory complications, it is recommended to use thymogen immunomodulator within 4-5 days after surgery at a dose of 0.1 ml for animals weighing up to 10 kg, 1 ml for animals weighing from 10 to 100 kg and 1 ml per 100 kg masses to larger individuals. Before the operation, 0.03-0.07 mg is administered intramuscularly per 1 kg of weight of a 10% solution of aminocaproic acid (ACC). It is desirable to wash the surgical wound abundantly with a 0.5% solution of ethonium or catapol (surface-active antiseptics - PAA).
The use of thymogen (or thymalin) during abdominal operations allows to normalize the amount total protein in blood serum, to increase the functional activity of cellular and humoral immunity, to increase the resistance of animals to surgical stress, to reduce the severity of postoperative depression. In operations such as hernia repair, debridement various mechanical damage, inclusion in complex therapy thymogen (or thymalin), PAA, ACC, led to wound healing by primary intention in 96% of cases (V.N. Vision).
Test questions. 1. What are Clinical signs inflammation of the preputial sac in sires, rams and boars? 2. What is the essence of the inflammatory process of fasting, balanitis, balanoposthitis in animals different types? 3. In what cases is sacral, conduction or infiltration anesthesia of the penis used according to I. I. Magda, I. I. Voronin? 4. What methods of treatment are used for inflammation of the preputial sac in animals various kinds? 5. What are features phimosis and paraphimosis in animals? 6. How are horses and sires treated for paraphimosis? 7. What are the clinical signs of paralysis of the penis in horses, rams, valukhs? 8. What are the distinguishing features of a hematocele, varicocele, hydro-cele? 9. How is periorchitis, orchitis, epididymitis treated? 10. What neoplasms are found on the penis and prepuce in animals? What methods of treatment can be recommended for this pathology? 11. What post-castration complications do you know, what is their differential diagnosis? 12. How are complications associated with percutaneous castration in animals?
The human genital organs are formed in the womb under the influence of endo and exogenous factors, develop during puberty. There are diseases, developmental anomalies that affect their function. These include the cyst of the spermatic cord (Funiculocele).
funiculocele
A cyst is a cavity filled with some kind of content. In the case of a funiculocele, the cavity is located in the scrotum. Consists of thin connective tissue, contains a clear serous fluid without impurities.
In the ICD-10, this disease has the code N43 (it includes, due to anatomical features, hydrocele and epididymal cyst). Funiculocele is located along the spermatic cord, has a round or oval shape, elastic structure. Dropsy is mobile on examination, painless.
Funicular - what is it?
Causes and types
These cysts are congenital and acquired during life, most often in men 20-40 years old. They can have one cavity (single-chamber) or several (multi-chamber). Pathology is common, does not pose a threat to reproduction and erectile function.
The cause of the development of the disease in children is a violation of embryogenesis: incomplete infection of the primary process, from which the membranes of the spermatic cord are formed (normally, it should be completely overgrown).
In the third month of pregnancy, the egg is laid in the embryo. Its promotion is carried out over the next five. The most critical for the formation of defects in the spermatic cord (SC) is the ninth month of pregnancy.
During this period, the testicle descends into the scrotum, and the primary process should be overgrown by the time of delivery. The testicle should be in a closed cavity, and the spermatic cord with membranes should be surrounded by tissues, vessels, and nerve endings.
Formation of the male reproductive organs 
Factors of dysembryogenesis - external and internal harmful effects that can pervert the natural process of embryo development:
- genetic mutations;
- hormonal disorders in the mother's body;
- transferred viral and bacterial infections;
- harmful chemical compounds, alcohol, smoking;
- medicines prohibited during pregnancy;
- contraceptives;
- radiation;
- oligohydramnios, benign tumors uterus;
- pregnancy on the background of the IUD.
If you imagine a long balloon (primary process), flattened on both sides for one third, which is filled with liquid, this is an isolated funiculocele.
If the cavity is filled only at the top, and the lower part is overgrown, the funicocele communicates with abdominal cavity. It is formed along the course of the spermatic cord, which supplies blood to the testicle and removes the seed to the vas deferens.
Cyst isolated connective tissue, autonomous. Cause of acquired funiculocele: inflammatory diseases, trauma to the scrotum, surgery for varicocele, circulatory disorders (venous congestion).
As a result of infection, the tissues swell, fluid can sweat out and accumulate between the shells of the SC:
- - inflammation of the testicle (infection is carried into the spermatic cord by blood flow);
- - inflammation of the epididymis;
- Funiculitis -;
- Deferentitis is an inflammation of the vas deferens.
These processes are caused by gonococci, trichomonads, mycoplasmas, chlamydia, tubercle bacillus. May be of traumatic origin.
In the photo funiculocele 
Symptoms
Small dropsy flow without specific complaints. Can be found at preventive examination, self-examination. In children, they are determined during bathing, but babies do not show any negative emotions with small cysts.
The large size of the formation, due to the good blood supply and innervation of the organ, can cause swelling, pain in inguinal region from the water side.
In children, symptoms may appear during puberty. But more often it decreases due to the overgrowth of part of the duct, the development of good blood supply and lymph outflow.
Diagnostics
Dropsy is found during a urological examination. Palpation determines the presence of a mobile, ovoid shape, elastic formation with clear boundaries. It is located along the spermatic cord, smooth to the touch.
With such a picture, one can suspect a funiculocele, an inguinal hernia, a spermatogenic granuloma, a tumor of the spermatic cord. Unlike inguinal hernia, dropsy of the spermatic cord has a constant size when straining or screaming.
For the diagnosis of spermatic cord cysts, additional methods examinations.
Funiculocele is confirmed by sonography, biopsy, diaphanoscopy:
- Diaphanoscopy is performed without pre-training. Using an electric diaphanoscope, the scrotum is translucent with a beam of directional light. soft tissues transmit light worse than liquid and air. Therefore, over the cyst will be characteristic symptom translucence.
- Sonography of the scrotum allows you to see fluid formation, determine its size, consistency, localization. But the nature of the structure of cells can only be determined by biopsy. This procedure is not done for the diagnosis of funicocele, since it is subjected to surgical removal.
- Pathological examination: the removed mass is sent for histology. A pathologist can make a definitive diagnosis by examining the preparation under a microscope.
Treatment is started after confirmation of the diagnosis and exclusion of a similar pathology from other urological organs.
In the video, a multi-chamber cyst of the spermatic cord (funicular cell):
Treatment
With a cyst of the spermatic cord of a small size in an infant - up to two years old, expectant tactics are used. In most cases, they decrease in size and require observation.
The operation is resorted to in cases of large funiculocele and pain syndrome. Initially, the cyst is punctured: after treating the scrotum, the formation is punctured with a special needle, the liquid is sucked off, and a bandage is applied.
But dropsy tends to relapse. After two or three punctures, with the next recurrence, they offer surgical treatment. The operation is under local anesthesia, the incision is made along the scrotum. In the depths of the wound, a cyst is found, bandaged at the base, cut off.
The postoperative wound is sutured, the removed cyst is sent for histological examination in order to exclude malignant growth. Immediately after surgery, patients apply ice to the wound to avoid swelling and bruising.
Within two months after the operation, it is recommended to wear tight swimming trunks, not to lift weights for prevention. incisional hernias. Thus, the operation leads to a complete cure, most urologists prefer this particular method of treating children and adults.
A complication of a cyst of the spermatic cord may be its rupture. It occurs after blows to the scrotum. It is technically easier to remove an entire formation located among healthy tissues.
Prophylactically, such patients should avoid injuries in the groin area. The prognosis for this pathology is favorable.
spermatozoal granuloma(Greek sperma, spermat seed + zoon living being, granuloma) - a productive inflammatory process in the epididymis, less often in the testicular tissue or in the wall of the vas deferens, caused by the penetration of spermatozoa from the lumen of the ducts into the surrounding tissue.
SPERMATOZOAL GRANULOMA occurs mainly up to 30 years. The epididymis of the right testicle (its head and body) is more often affected, in about 14% of patients - both epididymis. Most often, this year occurs as a result of a previous inflammatory process in the ducts of the epididymis, after damage to the vas deferens or as a complication after resection of the spermatic cord, a plastic surgery undertaken to restore the patency of the vas deferens with obstructive azoospermia (see). Inflammatory changes in the epididymis of a specific or nonspecific etiology are usually the main condition predisposing to the development of this year. Approximately 50% of patients simultaneously with this year have a tuberculous process in the epididymis, 30% have nonspecific epididymitis (see). Due to cicatricial narrowing of the ducts of the epididymis, their patency is disturbed, stasis of the contents occurs, and then focal destruction of the epithelial cover and basement membrane of the ducts, which contributes to the penetration of spermatozoa (see) into the surrounding interstitial tissue. It is also possible this year's development due to an aseptic inflammatory process. In the tissue of the testicle, this year occurs with the so-called. granulomatous orchitis (see).
Morphologically, three stages of development of this year are distinguished. In the first stage, spermatozoa and seminal fluid penetrate from the ducts of the epididymis into its tissue. In the second stage, a granulomatous reaction occurs in the epididymal tissue around the spermatozoa and seminal fluid that have penetrated into it, which is expressed in the accumulation of leukocytes, epithelioid, plasmatic and giant cells, as well as macrophages that phagocytize spermatozoa. The maturing granulation tissue (see) is enriched with collagen fibers. In the third stage, scarring of the granuloma occurs, while lymphoid infiltration and fibrosis are observed along its periphery, the severity of which depends on the duration of the process.
The affected epididymis on the cut is white-gray with yellow-brown foci, along the periphery the consistency of the epididymis is softer than in the center. Patients are concerned about aching pain in the scrotum, aggravated by walking and ejaculation. The epididymis, rarely the testicle itself, gradually increase. Palpation reveals a dense, painless infiltrate ranging in size from 3-5 mm to 7 cm. In 1/3 of patients, the appendage becomes bumpy. At the same time, the spermatic cord is compacted or clearly changed. Most patients have signs of tuberculous or nonspecific epididymitis.
Diagnosis establish at gistol. study of material obtained by biopsy.
Differential diagnosis carried out with tuberculous and nonspecific epididymitis (see), malacoplakia (see), neoplasms of the epididymis and the testicle itself (see).
Treatment mostly operational: produce epididymectomy (excision of the epididymis). At This year, testicles are resected or removed according to indications. With S. of the vas deferens, resection of the affected area of the duct is necessary with the imposition of an end-to-end anastomosis.
Forecast favorable for reproductive and sexual functions with unilateral lesions.
Bibliography: Lysov A. I. and Berezovskaya E. K. On the issue of spermatozoal granuloma of the epididymis, Urology, No. 1, p. 36, 1958; Multi-volume guide to pathological anatomy, ed. A. I. Strukova, vol. 7, p. 334, M., 1964; Morgenstern 3. On the issue of sperm-myophagy, Proceedings of the 1st All-Russian. Congress of Pathologists, p. 415, M., 1925; Shperl and ng ID Clinical and morphological characteristics of spermatozoal granuloma of the epididymis, Urology, No. 1, p. 34, 1964; Capers T. H. Granulomatous, orchitis with sperm granuloma of epididymis, J. Urol. (Baltimore), v. 87, p. 705, 1962; Holstein A. F. Morphologische Studien am Nebenhoden des Mensclien, S. 54, Stuttgart, 1969; Lyons R. C., Petre J. H. a. L e e C. N. Spermatic granuloma of the epididymis, J. Urol. (Baltimore), v. 97, p. 320, 19G7; Sundarasiva-r a o D. Spermatozoal granuloma of the epididymis, J. Path. Bact., v. 69, p. 324, 1955.
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