Carcinoma de células escamosas (cce) em cão na região prepucial: relato de caso / Squamous cell carcinoma (scc) in dog in the preputial region: case report / Carcinoma de células escamosas (cce) en perro de la región prepucial: reporte de un caso

A expectativa de vida dos animais de companhia vem aumentando devido as mudanças comportamentais e de cuidados dos tutores. Em analogia, com as idades cada vez mais avançadas, é comum o desenvolvimento de doenças associadas, sendo o tumor o mais comum entre elas. Todavia, as neoplasias mais comuns na clínica de pequenos animais estão associadas ao sistema tegumentar. O carcinoma de células escamosas (CCE), ou carcinoma espinocelular, é uma neoplasia de epitélio, maligno, de crescimento lento e de baixo potencial metastático. Sua etiologia ainda não é precisamente conhecida e a causa exógena mais comum e descrita pela literatura é a exposição à luz ultravioleta, gerando consequentes lesões nas estruturas genéticas e imunogênicas na pele. Além disso, essas lesões apresentam-se de forma mais comum em animais de pelagem clara, com grande exposição solar e em área anatômicas hipopigmentadas. O prognóstico varia de acordo com a localização e o estágio clínico, sendo favorável o diagnóstico realizado precocemente, e o tratamento consiste na avaliação clínica seguida do protocolo adequado O presente relato de caso tem como objetivo principal reunir e discutir informações associadas sobre o carcinoma de células escamosas em caninos e felinos, abordando aspectos clínicos e patológicos, a fim de facilitar o raciocínio sobre o CCE, desde sua abordagem inicial, até seu diagnóstico final e estadiamento.(AU)

The life expectancy of companion animals has been increasing due to behavioral and care changes of the guardians. In analogy, with the increasingly advanced ages, the development of associated diseases is common, the tumor being the most common among them. However, the most common neoplasms in the small animal clinic are associated with the integumentary system. Squamous cell carcinoma (SCC), or squamous cell carcinoma, is a malignant, slow-growing, low-potential metastatic epithelial neoplasm. Its etiology is not yet precisely known and the most common exogenous cause described by the literature is exposure to ultraviolet light, generating consequent lesions on the genetic and immunogenic structures in the skin. In addition, these lesions are more common in light-haired animals, with high exposure to the sun, and in hypopigmented anatomical areas. The prognosis varies according to the location and clinical stage, being favorable to the early diagnosis, and the treatment consists in the clinical evaluation followed by the appropriate protocol. The present case report has as its main objective to gather and discuss associated information about squamous cell carcinoma in canines and cats, addressing clinical and pathological aspects, in order to facilitate the reasoning about the CCE, from its initial approach, to its final diagnosis and staging.(AU)

La esperanza de vida de los animales de compañía ha ido en aumento debido a los cambios de comportamiento y cuidado de los guardianes. Por analogía, con las edades cada vez más avanzadas, el desarrollo de enfermedades asociadas es común, siendo el tumor el más común entre ellos. Sin embargo, las neoplasias más comunes en la clínica de animales pequeños se asocian con el sistema tegumentario. El carcinoma epidermoide (CCE), o carcinoma epidermoide, es una neoplasia epitelial metastásica maligna de crecimiento lento y bajo potencial. Su etiología aún no se conoce con precisión y la causa exógena más común descrita por la literatura es la exposición a la luz ultravioleta, generando lesiones consecuentes en las estructuras genéticas e inmunogénicas de la piel. Además, estas lesiones son más comunes en animales de pelo claro, con alta exposición al sol, y en áreas anatómicas hipopigmentadas. El pronóstico varía según la localización y el estadio clínico, siendo favorable al diagnóstico precoz, y el tratamiento consiste en la evaluación clínica seguida del protocolo adecuado. El presente reporte de caso tiene como objetivo principal reunir y discutir información asociada sobre el carcinoma epidermoide en caninos y gatos, abordando aspectos clínicos y patológicos, con el fin de facilitar el razonamiento sobre el CCE, desde su abordaje inicial, hasta su diagnóstico final y estadificación.(AU)

Síndrome da feminização em cão com sertolioma / Feminization syndrome in a dog with Sertoli cell tumor

Background: The uncontrolled multiplication of Sertoli cells causes Sertoli cell tumor or Sertolioma. Because of this, the level of estrogen in the bloodstream increases rapidly and approximately 25% of dogs with this tumor develop feminization syndrome. Testicular neoplasms are more common in dogs than cats, and are often found in elderly patients. This work aims to describe the clinical signs of the feminization syndrome and the treatment instituted in a canine diagnosed with sertolioma. Case: A 18-year-old male canine, 19.5 kg of body mass, with an increase in testicular volume for about 2 years, was treated at the University Veterinary Hospital. On clinical examination, a matte and brittle coat, alopecia on the hind limbs and gynecomastia were observed. Also noted, non-harmonious aspect of the scrotum, pendular foreskin, atrophied right testicle and hyperplastic left, scrotal hyperthermia and absence of pain. In addition, as a result of the hyperestrogenism resulting from the neoplasm, the paraneoplastic syndrome of feminization, the patient also presented galactorrhea, pendular foreskin, atrophy of the penis and the contralateral testicle, dermatopathies, such as bilateral symmetrical alopecia of the flanks, easily removable hair and variable hyperpigmentation. Rectal body temperature of 38.6°C, clear lung auscultation and muffled cardiac auscultation. The results of laboratory tests showed changes such as thrombocytopenia, platelet counts below the reference levels, platelet count of 163,000/uL. There were no alterations that represented metastases in the imaging exams, such as in the chest X-ray in three incidences and in the abdominal ultrasonography. Then, we opted for the surgical procedure of orchiectomy, with the traditional technique of three clamps, associated with total ablation of the scrotum. Samples were sent to the histopathology laboratory and the diagnosis of sertolioma was confirmed. At 10, 30 and 90 days after the operation, the patient was reassessed for possible recurrences or alterations, but there were no complications or recurrence after the procedure. Discussion: Neoplasms of the male reproductive system are common in dogs. Sertolioma is considered one of the most frequent neoplasms in elderly dogs and that results in systemic clinical signs. This is in line with the 18-year-old dog described in the present report. In addition, it may result in clinical signs resulting from hyperestrogenism resulting from the neoplasm that is called paraneoplastic feminization syndrome. The characteristics of this syndrome are: gynecomastia, galactorrhea, pendular foreskin, atrophy of the penis and contralateral testicle, associated with dermatopathies, such as symmetrical bilateral alopecia. All these clinical signs were present. The diagnosis is made through complete anamnesis, complete clinical examination and complementary examination such as ultrasound help in the presumptive diagnosis, but only with histopathology can it be confirmed. In the clinical approach, histopathology was performed to close the diagnosis. Treatment is behind orchiectomy and total ablation of the scrotum, which was performed in the reported case. The treatment of choice was easy to apply, in addition to improving the patient's quality of life, promoting rapid post-surgical healing and an early return to normal life. However, for the effectiveness of the technique, the early diagnosis and collaboration of tutors is fundamental.

Hipospadia peniana em cão ­ Relato de caso / Penile hypospadias in a dog - Case report / Hipospadias peneana en un perro ­ Reporte de caso

A hipospadia é oresultado de falha no desenvolvimento em que não ocorre a fusão normal das dobras genitais e intumescência genital, o que causa desenvolvimento anormal da uretra peniana, do pênis, prepúcio e/ou escroto. O objetivodeste relato é descrever um caso de hipospadia peniana de um canino macho, sem raça definida (SRD), de oito meses deidade, atendido no Hospital Veterinário da Universidade Federal Rural da Amazônia, na cidade de Belém/Pará, detalhando os procedimentos cirúrgico e anestésico utilizados para resolução do caso. Ao chegar ao hospital, o animal foi submetido ao exame físicoinicial no qual observou-se uma deformidade na região perianal por onde drenava a urina e uma abertura na região prepucial. A partir disso, foi solicitada a uretrocistografia retrógrada para complemento diagnóstico da hipospadia e seu comprometimento ao sistema urinário interno. Diante disso, foi realizado procedimento cirúrgico reconstrutivo e orquiectomia terapêutica, alcançando permitindoa resolução do caso e a recuperação completa do animal. Considerando que essa deformidade impossibilita a capacidadesexual generandi, a resolução recomendada é a cirúrgica, na qual o prognóstico é bom, possibilitando qualidade de vida ao animal.(AU)

Hypospadias is the result of developmental failure where normal fusion of the genital folds and genital tumescence does not occur, which causes abnormal development of the penile urethra, penis, foreskin and/or scrotum. The objective of this report is to describe a case of penile hypospadias in an eight-month-old male mixed breed (SRD) canine, treated at the Veterinary Hospital of the Federal Rural University of Amazônia, in the city of Belém/Pará, detailing the procedures surgical and anesthetic used for resolution of the case. Upon arrival at the hospital, the animal underwent an initial physical examination in which a deformity was observed in the perianal region through which urine drained and an opening in the preputial region. From this, a retrograde urethrocystography was requested to complement the diagnosis of hypospadias and its commitment to the internal urinary system. In view of this, a reconstructive surgical procedure and therapeutic orchiectomy were performed, allowing the resolution of the case and the complete recovery of the animal. Considering that this deformity prevents the sexual capacity generandi, the recommended resolution is surgery, in which the prognosis is good, allowing quality of life for the animal.(AU)

La hipospadias es el resultado de una falla en el desarrollo donde no ocurre la fusión normal de los pliegues genitales y la tumescencia genital, lo que provoca un desarrollo anormal de la uretra peneana, el pene, el prepucio y/o el escroto. El objetivo de este relato es describir un caso de hipospadias peneana en un canino macho mestizo (SRD) de ocho meses de edad, atendido en el Hospital Veterinario de la Universidad Federal Rural de Amazônia, en la ciudad de Belém/Pará, detallando los procedimientos quirúrgicos y anestésicos utilizados para la resolución del caso. A su llegada al hospital, el animal fue sometido a un examen físico inicial en el que se observó una deformidad en la región perianal por donde salía la orina y una abertura en la región prepucial. A partir de ello se solicitó cistouretrografía retrógrada para complementar el diagnóstico de hipospadias y su afectación en el sistema urinario interno. Ante esto, se realizó un procedimiento quirúrgico reconstructivo y orquiectomía terapéutica, que permitió la resolución del caso y la recuperación completa del animal. Teniendo en cuenta que esta deformidad imposibilita la capacidadgeneradi sexual, la resolución recomendada es la cirugía, en la que el pronóstico es bueno, permitiendo calidad de vida para el animal.(AU)

Hypospadias in two cats: case report / Hipospadia em dois gatos: relato de caso

Hypospadias is an uncommon sexual development disorder in cats, in which the urethral opening is not in its anatomical location on the penis. The purpose of this report is to describe two cases of hypospadias in the feline species. The first cat was asymptomatic, had a history of bacterial cystitis, and was diagnosed with perineal hypospadias at an appointment for preoperative evaluation of orchiectomy. The second cat had clinical signs of dysuria and pollakiuria for 30 days and had glandular hypospadias. Both cats showed abnormalities in the urinalysis which were suggestive of lower urinary tract disease. For both cases, clinical treatment with antibiotic therapy was performed. In the first patient, surgical treatment consisted of orchiectomy, while in the second animal a perineal urethrostomy and orchiectomy were performed. The cats had a satisfactory recovery after the treatments. Performing a thorough physical examination is essential to diagnose cases of hypospadias and choose the best treatment for each patient.

A hipospadia é uma desordem do desenvolvimento sexual pouco comum nos gatos, na qual a abertura uretral não está em sua localização anatômica do pênis. O objetivo do presente relato é descrever dois casos de hipospadia em felinos domésticos. O primeiro gato era assintomático, tinha histórico de cistite bacteriana prévio, e foi diagnosticado com hipospadia perineal em uma consulta para avaliação pré-cirúrgica de orquiectomia. O segundo gato apresentava sinais clínicos de disúria e polaquiúria há 30 dias e apresentava hipospadia glandular. A partir dos exames complementares, pôde-se observar que os animais, além do defeito anatômico, apresentavam alterações sugestivas de doença do trato urinário inferior. Para ambos os casos, foi realizado o tratamento clínico inicial com antibioticoterapia. No primeiro paciente, optou-se pelo procedimento de orquiectomia, enquanto no segundo animal foram realizadas as técnicas de uretrostomia perineal e orquiectomia. Os gatos mostraram recuperação satisfatória após os tratamentos instituídos. Dessa forma, pode-se observar a importância de se realizar um exame físico minucioso a fim de diagnosticar os casos de hipospadia e escolher o tratamento correto para cada paciente.

Administration with L-glutamine and L-glutathione protects the nitrergic innervation of the penile tissue of diabetic rats

Erectile dysfunction is caused due to neuropathy, resulting from a high oxidative stress, in this way treatment with antioxidants may be promising. Aim of this work was toinvestigate the effects of the administration of 2% L-glutamine and 1% L-glutathione on the penile tissue of diabetic rats analyzing the nerve fibers that expressing Nitric Oxide Synthase Neuronal (nNOS). Forty-eight male Wistar rats distributed into six groups were used: normoglycemic, diabetic, normoglycemic administered with 2% L-glutamine, normoglycemic administered with 1% L-glutathione, diabetic administered with 2% L-glutamine, and diabetic administered with 1% L-glutathione. After a 120 days experimental period, the animals were euthanized, and the penile tissues were collected and processed for the subsequent immunohistochemical procedure (nNOS) and posterior varicosities morphometry analysis. Diabetic rats administered with L-glutamine and with L-glutathione displayed larger varicosity areas of 14 and 15% compared to the diabetic group (p < 0.05). On the other hand, the administration of 2% L-glutamine and 1% L-glutathione in normoglycemic animals promoted a reduction of 3.3% and 2.4% compared to the normoglycemic group (p < 0.05). We concluded that both L-glutamine and L-glutathione administrations exerted a protective effect on the penile nitrergic innervation of diabetic rats, which can have a positive impact on the erectile function and thattheir use in normoglycemic animals should be better investigated.(AU)

Penile fractures in young bulls raised in feedlots in Southern Brazil

Background: Penile fracture is a pathology of young cattle that perform precocious and disordered breeding. The incompatibility of height between males and females and sodomy between males cause a great pressure on the sigmoid flexure and retractor muscle of the penis, which are the main causes and sites of organ injury. This study aimed to describe the epidemiological and pathological aspects of penile fractures observed in young bulls raised in pre-export feedlots (PEFs) in southern Brazil. Cases: In 2 PEFs located in the municipalities of Pelotas (property 1) and Capão do Leão (property 2), 3 male cattle [1 from property 1 and 2 from property 2] presented subcutaneous edema in the foreskin and perineum, associated with dysuria. The evolution of the clinical picture was approximately 20 days in all cases, with evolution to death. The bovine necropsied on property 1 had an increased volume and inguinal edema, involving the penis and scrotal sac. Necrosis of the subcutaneous tissue and local musculature was also observed. The testicles were surrounded by the necrotic tissue, and the right testis was swollen, with flaccid parenchyma adhering to the tunica albuginea. In the necropsy of 1 bull from property 2, an increase in the inguinal volume was observed, with an extensive area of necrosis and edema extending from the prepuce to the caudal musculature of the scrotal sac. There were also marked varicosis in the sigmoid flexure and necrosis of the adjacent region, without the involvement of the corpus cavernosum. During the necropsy of the 2 young bulls, fragments of organs from the abdominal, thoracic, and brain cavities were collected and fixed in 10% buffered formalin. From the bull of the property 2, an anatomical piece consisting of the penis, prepuce, and testicles was also collected and fixed in 10% buffered formalin. After 48 h, the tissue samples were cleaved, embedded in paraffin, cut into 3-µm-thick sections, and stained using hematoxylin and eosin (HE). A histological evaluation of the penile lesions in both cattle revealed intense hemorrhage, congestion, and necrosis of the muscles and tissues adjacent to the corpus cavernosum. In addition to areas of dystrophic calcification, neutrophil and macrophage infiltration was also observed. In the bull from the property 1, an intense edema and proliferation of fibrous tissue surrounding the urethra were noted. There were also marked tubular degeneration and intense infiltration of neutrophils, lymphocytes, and macrophages in the inner portion of the tunica albuginea. Discussion: In the present cases, the diagnosis was based on epidemiological data associated with clinical signs and pathology. The macroscopic lesions observed were probably due to the involvement of blood vessels adjacent to the penis, which suffered trauma during sodomy mating among cattle. These lesions have been described in other reports of this pathology and in diseases, such as acropostitis-phimosis, fibropapilloma of the glans, preputial abscess, and urolithiasis, and the differential diagnosis of these diseases must be carried out, as they have different etiologies. In the bulls of the present study, no lesions were observed in the corpus cavernosum, and this condition was attributed to the presence of varicosis and accumulation of urine in the prepuce, due to the difficulty in exposing the penis. Histologically, there were intense hemorrhage, congestion, and necrosis of the muscles and tissues adjacent to the corpus cavernosum, with the infiltration of neutrophils and macrophages, and areas of dystrophic calcification. The presence of necrotic lesions in tissues adjacent to the penis may be related to hypoxia, vascular lesions, or the action of chemical elements present in the urine. In both cases, vascular lesions were present, which were attributed to the main triggering factor for the disease.

Three new Dactylogyrus species (Monogenea: Dactylogyridae) and redescription of one other, gill parasites of five Labeo spp. (Cypriniformes: Cyprinidae) from the Sanaga basin (Cameroon, Central Africa)

ABSTRACT Three new and one already known species of Dactylogyrus Diesing, 1850 are described from five species of Labeo (Cyprinidae) sampled in the middle section of the Sanaga hydrosystem (Centre Region-Cameroon): Dactylogyrus sanagaensis sp. nov. from Labeo sanagaensis Tshibwabwa, 1997, L. nunensis Pellegrin, 1929, L. camerunensis Trewavas, 1974 and L. annectens Boulenger, 1903; Dactylogyrus nachtigalensis sp. nov. and D. yassensis Musilová, ehulková & Gelnar, 2009 from Labeo batesii Boulenger, 1911; and Dactylogyrus djimensis sp. nov. from Labeo camerunensis. Dactylogyrus sanagaensis sp. nov. is close to D. longiphalloides, D. longiphallus, D. leonis, D. marocanus, and D. dembae, however it can be easily distinguished from these species by the size of MCO. Dactylogyrus nachtigalensis sp. nov. is similar to D. dembae and D. sanagaensis sp. nov. but this new species can be mainly differentiated by the length of penis. Dactylogyrus djimensis sp. nov. mostly similar to D. omega can be differentiated from it by the penis diameter. Dactylogyrus yassensis collected from Cameroon doesnt significantly differ morphometrically from the original description, thus extends the distribution of this species to Sanaga basin. Monogenean species collected from Labeo spp. in the middle section of the Sanaga hydrosystem were classified into two morphological groups: the pseudanchoratus-like group and the cyclocirrus-like group newly defined herein. Phylogenetic relationships are suggested among Dactylogyrus species.

Morphological and morphometric characterization of the preputial ostium, internal preputial leaflet, and free part of the penises of Aberdeen Angus and Nellore bulls / [Caracterização morfológica e morfométrica do óstio prepucial, do folheto prepucial interno e da parte livre do pênis de touros Aberdeen Angus e Nelore]

The morphological characteristics of the external genitalia of the bull may contribute to the etiopathogenesis of preputial diseases that trigger the impotence coeundi and losses in farms. The goal of this study was to establish morphometric parameters of the preputial ostium, the internal preputial leaflet (IPL), the free part and glans of the penis; describe the histological characteristics of the IPL; perform a count of the preputial sebaceous glands and compare these variables between 24-month-old Aberdeen Angus and Nellore bulls. At the slaughterhouse, 20 preputial pieces were collected from each breed. A device composed of base, rod, ring, and funnel was designed to hold each suspended and distended part. The IPL, the free part of the penis and the glans were measured. The ostium diameter was measured, and the radius, perimeter, and area of the preputial ostium were calculated. Samples were collected from the dorsal and ventral regions and from the cranial, medial, and caudal portions of the IPL. By electronic and optical microscopy, IPL characterization and sebaceous gland counts were performed. Analysis of variance was performed using the F test at 5%. It was concluded that Nellore bulls have a more extensive IPL and free part of the penis and more preputial sebaceous glands than Aberdeen Angus bulls. In both breeds, there are more glands in the ventral region of the ostium.

As características morfológicas da genitália externa do touro podem contribuir para a etiopatogenia de enfermidades prepuciais que desencadeiam a impotência coeundi e prejuízos nos criatórios. O objetivo deste estudo foi estabelecer parâmetros morfométricos do óstio prepucial, do folheto prepucial interno (FPI), da parte livre e da glande do pênis; descrever as características histológicas do FPI; realizar contagem de glândulas sebáceas prepuciais; e comparar essas variáveis entre touros Aberdeen Angus e Nelore, com 24 meses de idade. No abatedouro, colheram-se 20 peças prepuciais de cada raça. Elaborou-se um dispositivo composto por base, haste, anel e funil para sustentar cada peça suspensa e distendida. Realizou-se medição do FPI, da parte livre do pênis e da glande. Aferiu-se diâmetro do óstio, e calculou-se o raio, o perímetro e a área do óstio prepucial. Colheram-se amostras nas regiões dorsal e ventral e das porções cranial, medial e caudal do FPI. Por microscopia eletrônica e óptica, fez-se a caracterização do FPI e a contagem de glândulas sebáceas. Realizou-se análise de variância pelo teste F a 5%. Concluiu-se que touros Nelore possuem o FPI e a parte livre do pênis mais extensos e mais glândulas sebáceas prepuciais que touros Aberdeen Angus. Nas duas raças, há mais glândulas na região ventral do óstio.

Reconstrução prepucial com uso de enxerto combinado em cães / Preputial reconstruction combined with graft in dogs

Background: Preputial injuries are significant in the clinical routine. Traumas, conditions, and mass excision result in extensive and full-thickness defects that lead to chronic penile exposure and consequential injuries. Severe injuries may require preputial reconstructive surgery to restore function and aesthetics. The objective is to report the use of the preputial reconstruction technique using the caudal superficial epigastric axial standard flap associated with a single-stage, full-thickness oral mucosa graft in 3 dogs where the loss of the prepuce was significant. Cases: Three dogs were admitted to the Veterinary Teaching Hospital of UFMT with preputial lesions of different etiologies. All cases were referred for preventive reconstruction using a flap in the caudal axial epigastric pattern associated with a single-stage oral mucosa graft. In the 3 reported cases, changes that compromised surgical success, such as suture dehiscence, necrosis, or infection, were not observed during hospitalization. Cutaneous stitch dehiscence, however, was observed in all 3 cases. Dog 1. A small point of dehiscence and tissue necrosis was found and treated with chemical debridement and healed by second intention, which proved to be sufficient on the 30th day. Dog 2. A half-moon rotation flap was performed, which closed the defect. Dog 3. A new procedure using the reporting theme technique was necessary in order to cover the cranial portion of the foreskin. The dehiscence present in dogs 2 and 3 was significant. Flap retraction was observed in all 3 cases. In dogs 1 and 3, the retraction was slight, and the exposure of a small portion of the penile glans were observed, showing no changes that required intervention. In dog 2, retraction was important, leading to partial stenosis of the preputial ostium. A larger ostium was obtained by suturing the mucosa to the edge of the wedge. Considering the possibility of adhesion formation, "captons" were made in sterile silicone tubes, and sutures were placed in the dorsal and ventral aspects to prevent adherence of the oral mucosa graft located on the inside of the new foreskin. The captons were removed on the tenth post-operative day, revealing a good opening of the preputial orifice and adequate penile exposure. Discussion: The absence of a foreskin caused by trauma or surgical excision leads to chronic penile exposure, dryness, and ulcerations. The simple covering of the skin with an axial-type flap of the caudal superficial epigastric region tends to fail since only the graft edges are sutured into the abdominal skin. In these circumstances, the subcutaneous region on the penis is exposed and comes in direct contact with urine and the penile mucosa, causing the flap skin to grow to exacerbated retraction. The transplantation of a free-lip mucosa graft allows the subcutaneous region of the transposed skin flap to create adhesions in the fenestrated regions of the lip tissue through the formation of granulation tissue buds, which is performed in a single stage. The permanence of the penis protects the lower urinary system from the occurrence of infections relative to what is normally observed in cases where partial or total penile amputation is practiced in combination with adjunctive scrotal urethrostomy. Given the observations of the 3 cases described here, the technique of pre-facial reconstruction with an axial skin flap of the caudal superficial epigastric region, combined with free-labial mucosa graft, was found to be feasible for the single-stage foreskin technique, but that paraphimosis remanagement may be necessary when cutaneous portions of the penile skin caudal to the glans are removed.

Identification of Pentatrichomonas hominis in preputial washes of bulls in Brazil / Identificação de Pentatrichomonas hominis em lavado prepucial de touros no Brasil

The parabasalid Pentatrichomonas hominis is generally considered to represent a symbiotic component of the gastrointestinal microbiota in a wide variety of vertebrate hosts including humans. Nevertheless, a limited number of studies have raised the possibility that it may act as a pathogen of humans, dogs, and pigs and that some human infections may have a zoonotic origin. Data from North America revealed an association between P. hominis and the bovine urogenital tract, principally in bulls and rarely in cows. The importance of this observation is linked to possible interference in the accurate diagnosis of the economically important venereal pathogen Tritrichomonas foetus. The current study employed culture-based and molecular methods to examine the preputial cavities of four breeding bulls, raised in open pasture in southeastern Brazil, for the presence of trichomonads. Motile protozoa were isolated from three of the bulls and were definitively identified as P. hominis based on nucleotide sequencing of polymerase chain reaction (PCR) amplicons derived from the ribosomal RNA operon (ITS1-5.8S rDNA-ITS2) of the parasite. The potential implications of these findings for bovine and human health are discussed.(AU)

O parabasalídeo Pentatrichomonas hominis é geralmente considerado um componente simbiótico da microbiota gastrointestinal em uma ampla variedade de hospedeiros vertebrados, incluindo os humanos. No entanto, um número limitado de estudos levantou a possibilidade de que possa atuar como patógeno de humanos, cães e suínos, e que algumas infecções humanas possam ter origem zoonótica. Dados da América do Norte revelaram uma associação entre P. hominis e o trato urogenital bovino, principalmente, em touros e raramente em vacas. A importância dessa observação está ligada a uma possível interferência no diagnóstico preciso do patógeno venéreo de importância econômica Tritrichomonas foetus. O presente estudo empregou métodos baseados em cultura em combinação com técnicas moleculares, para examinar as cavidades prepuciais de quatro touros, criados em pastagem aberta no sudeste do Brasil, quanto à presença de tricomonas. Protozoários móveis foram isolados de três dos touros e foram definitivamente identificados como P. hominis com base no sequenciamento de nucleotídeos de amplicons geradas pela reação em cadeia da polimerase (PCR), empregando a região RNA ribossômico (ITS1-5.8S rDNA-ITS2) do parasita como alvo. Os potenciais implicações desses achados para a saúde bovina e humana são discutidas.(AU)

Three new Dactylogyrus species (Monogenea: Dactylogyridae) and redescription of one other, gill parasites of five Labeo spp. (Cypriniformes: Cyprinidae) from the Sanaga basin (Cameroon, Central Africa)

Three new and one already known species of Dactylogyrus Diesing, 1850 are described from five species of Labeo (Cyprinidae) sampled in the middle section of the Sanaga hydrosystem (Centre Region-Cameroon): Dactylogyrus sanagaensis sp. nov. from Labeo sanagaensis Tshibwabwa, 1997, L. nunensis Pellegrin, 1929, L. camerunensis Trewavas, 1974 and L. annectens Boulenger, 1903; Dactylogyrus nachtigalensis sp. nov. and D. yassensis Musilová, Rehulková & Gelnar, 2009 from Labeo batesii Boulenger, 1911; and Dactylogyrus djimensis sp. nov. from Labeo camerunensis. Dactylogyrus sanagaensis sp. nov. is close to D. longiphalloides, D. longiphallus, D. leonis, D. marocanus, and D. dembae, however it can be easily distinguished from these species by the size of MCO. Dactylogyrus nachtigalensis sp. nov. is similar to D. dembae and D. sanagaensis sp. nov. but this new species can be mainly differentiated by the length of penis. Dactylogyrus djimensis sp. nov. mostly similar to D. omega can be differentiated from it by the penis diameter. Dactylogyrus yassensis collected from Cameroon doesn't significantly differ morphometrically from the original description, thus extends the distribution of this species to Sanaga basin. Monogenean species collected from Labeo spp. in the middle section of the Sanaga hydrosystem were classified into two morphological groups: the 'pseudanchoratus-like group' and the 'cyclocirrus-like group' newly defined herein. Phylogenetic relationships are suggested among Dactylogyrus species.

Prolapso uretral em um cão da raça American Bully / Urethral prolapse in a dog of the American Bully breed

O prolapso uretral, o qual é incomum em cães, se caracteriza pela protusão da mucosa uretral além da extremidade do pênis e do orifício externo da uretra. Pode ocorrer por causas congênitas ou adquiridas, tendo maior incidência em animais jovens não castrados. O objetivo do presente trabalho é relatar um caso de prolapso uretral em um cão não castrado da raça American Bully Terrier, de dois anos, o qual foi atendido na Universidade Estácio de Sá localizada no Rio de Janeiro com histórico de lambedura excessiva do pênis, disúria, sangramento prepucial e protrusão da mucosa uretral após tentativa de cópula. Durante a avaliação física o animal apresentou todos os parâmetros clínicos dentro da normalidade, entretanto demonstrava agitação excessiva e dor na região afetada. Então, o diagnóstico foi definido por meio da inspeção direta da visualização da mucosa uretral protusa. Frente ao quadro clínico e físico do animal, foi adotado o procedimento cirúrgico de ressecção e anastomose da porção uretral prolapsada. Desta forma, conclui-se que esta técnica cirúrgica se mostrou eficaz, visto que o referido paciente apresentou ótima recuperação e cicatrização uretral, sem quaisquer sinais de complicações pós-cirúrgicas.

Urethral prolapse, which is uncommon in dogs, is characterized by protrusion of the urethral mucosa beyond the tip of the penis and the external orifice of the urethra. It can occur due to congenital or acquired causes, with a higher incidence in young animals not castrated. The present study aims to report a case of urethral prolapse in a non-castrated dog of 2 years old (American Bully Terrier), which was treated at the Estácio de Sá University located in Rio de Janeiro city, with a history of excessive penis licking, dysuria, prepucial bleeding, and protrusion of the urethral mucosa after an attempt of copulation. During the physical evaluation, the animal presented all clinical parameters within the normal range; however, it showed excessive agitation and pain in the affected region. Then, the diagnosis was defined through direct inspection of the visualization of the protruding urethral mucosa. Given the animal's clinical and physical condition, the surgical procedure of resection and anastomosis of the prolapsed urethral portion was adopted. Therefore, it is concluded that this surgical technique proved to be effective since the patient presented excellent recovery and urethral healing, without any signs of post-surgical complications.

Hermafroditismo verdadeiro na espécie suína / True hermaphroditism in the swine specie

Os hermafroditas verdadeiros são animais com intersexualidade, nos quais as gônadas masculinas e femininas se desenvolvem simultaneamente no mesmo indivíduo. Este trabalho relata um caso de hermafrodita na espécie suína após descarte de uma fêmea por diagnóstico de anestro. Tratava-se de uma fêmea com 222 dias de idade e 150 kg a qual havia sido selecionada para reprodução e permanecia em anestro. O indivíduo foi descartado e enviado para o abate em frigorífico sob inspeção federal. Após o abate foi observado no sistema genital aspectos anatômicos sugestivos de hermafroditismo. O sistema genital foi coletado, inspecionado macroscopicamente e conservado em formol a 10% para avaliação microscópica. Durante a análise macroscópica foi verificada a presença de vulva e vagina, contendo um pênis rudimentar. O útero, a cérvix, os cornos uterinos e oviduto estavam presentes e com ausência de anormalidade. Havia um ovário esquerdo com aspectos morfológicos de ciclicidade e folículos contendo oócitos de alta qualidade. À direita, entretanto, foi constatada a presença de um testículo, epidídimo e plexo pampiniforme. A avaliação histopatológica comprovou os achados macroscópicos, demonstrando um ovário contendo folículos, corpos lúteos e cistos foliculares; plexo pampiniforme; testículo e epidídimo com aspecto histológico normal, porém, com ausência de células espermatogênicas. Assim, com base nos achados macro e microscópicos descritos nesse relato de caso, o indivíduo foi considerado como hermafrodita verdadeiro.(AU)

True hermaphrodites are intersexual animals, in which both male and female gonads develop simultaneously in the same individual. This paper reports a case of a true hermaphrodite in the swine species after its culling for anestrus. The specimen was a female of 222 days of age and 150 kg of body weight, that was selected for reproduction and was permanently in anestrus. This individual was culled and sent to an abattoir under federal inspection. After slaughtering, it was observed in the reproductive tract anatomical aspects that suggested hermaphroditism. The reproductive tract was collected, evaluated macroscopically, and preserved in formaldehyde at 10 % to be evaluated by light microscopy. During the macroscopic analysis, the presence of a vulva and a vagina with a rudimentary penis was detected. The uterus, the cervix, uterine horns, and the oviduct were present and abnormalities were not detected. The left ovary exhibited morphological signs of cyclicity and contained follicles with high quality oocytes. On the right side, however, it was observed a testicle, epididymis, and a pampiniform plexus. The histopathological assessment corroborated the macroscopic findings, which demonstrated that the ovary had follicles, corpus luteum, and follicular cysts, and pampiniform plexus, testicle and epididymis were histologically normal, though with the absence of spermatogenic cells. Thus, based on the macro and microscopic findings described herein, the individual was considered a true hermaphrodite.(AU)

Anatomy of two species of Megalobulimus (Strophocheilidae, Megalobuliminae) from South-Central Bahia, Brazil

An anatomical and taxonomic study of Megalobulimus oblongus (Müller, 1774) and M. conicus (Bequaert, 1948) (Strophocheilidae, Megalobuliminae) is carried out, based mainly on samples from the south-central region of Bahia, Brazil. It revealed interesting anatomical differences in several structures, mainly in the pallial cavity, with greater ramification of vessels in the respiratory region of M. oblongus when compared to M. conicus; and in the genital system of M. conicus, which has a more elongated prostate, and the folds of the penis are more spaced. A taxonomical discussion is presented, including several characters confirmed as typical of the genus and subfamily, such as buccal flange, prerectal valve and pulmonary septum.(AU)

Urethral reconstruction combined with modified urethrostomy in a cat after prepubic urethrostomy

Background: In cats, urethral obstruction is generally caused by various reasons, including feline idiopathic cystitis, urethral crystals, urethral trauma, mucous plug, congenital or acquired anatomical deformity, and urolithiasis, especially in male cats. Depending on the severity and duration of clinical signs, immediate management including conservative or surgical therapy for restoration of urethral patency is required. Repetitive urethral obstruction due to intraluminal plugs, obstruction that cannot be resolved by medical management, and urethral strictures, trauma, or neoplasia should be managed by surgery. When the penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineal skin by repetitive perineal urethrostomy, prepubic urethrostomy is indicated. Potential complications of prepubic urethrostomy include urinary incontinence, peristomal dermatitis. In such cases, management of the peristomal site or placement of an artificial urethral sphincter have been reported previously. However, to date, urethral reconstruction using pre-existing penis has not been reported after prepubic urethral stricture following prepubic urethrostomy. The objective of this report is to describe surgical procedure of the urethral reconstruction combined with modified perineal urethrostomy in a cat with prepubic urethral stricture after prepubic urethrosotmy. Case: A 3-year-old castrated Scottish straight cat presented with dysuria after prepubic urethrostomy. The owner reported that the patient was diagnosed with urethral rupture, had undergone prepubic urethrostomy 2 months prior to presentation, and had persistent dysuria despite repetitive surgical revision of the prepubic urethral stoma at a local hospital. On physical examination, the preputial orifice and the penis appeared grossly normal. On ultrasonography, pericystic and periurethral fat had an edematous, striated appearance with alternating hyperechoic and anechoic regions. A small amount of free fluid was visible around the urethra. Abdominal radiography revealed a mildly distended bladder and loss of serosal detail around the area of the urinary bladder neck, consistent with inflammation and free fluid observed on ultrasonography. The retrograde urethrogram showed no leakage in either sites of the prepubic urethral orifice or the penis. Hence, complete urethral reconstruction with modified perineal urethrostomy was performed. The patient had normal urination at the 15-month follow-up. Discussion: Prepubic urethrostomy is beneficial for the patients whose penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineum. Complications of prepubic urethrostomy include skin necrosis around the stoma; urinary incontinence; stricture of the urethral stoma due to several reasons such as surgical-site irritation; poor mucosa-skin apposition; failure to provide tension-free stoma; and failure to expose wider pelvic urethra. In these cases, surgical management of the level of prepubic urethral stoma has been recommended by previous studies. However, no studies have been reported urethral reconstruction using pre-existing penile urethra in a patient with prepubic urethral stricture so far. To the author's knowledge, this case is the first report describing urethral reconstruction in a cat with urethral stricture after prepubic urethrostomy.

Anoftalmia bilateral em cão associada à malformação peniana congênita / Bilateral anophthalmia in dog associated with congenital penile malformation

Background: Anophthalmia refers to the complete absence of an eyeball. It is a very rare congenital condition that affects all breeds of dogs, which may be unilateral or bilateral. Anophthalmia results from a severe developmental deficiency in the primitive forebrain, prior to the formation of the optic sulcus. This condition has a complex etiology, and chromosomal, monogenic, and environmental causes have already been identified. There might be an association between anophthalmia and other congenital abnormalities. This case report aimed to report the case of a male dog with bilateral anophthalmia associated with penile malformation. Case: A 3-year-old male mongrel dog was evaluated in a clinical consultation at the Veterinary Medical Teaching Hospital of the Federal University of Piauí (UFPI) - Teresina - Brazil, with signs of anemia and diarrhea. His vaccinations were not up to date (multiple and anti-rabies), presented ectoparasites (ticks), and showed inappetence. The owner reported that the animal was blind from birth, was already well adapted to its environment, had the company of other animals, and had no access to the street. On clinical examination, the animal had a good body score. The eyelids were bilaterally present with normally developed eyelashes. Both the head and face had a symmetrical appearance, without structural abnormalities, and the palpebral fissures were narrow. When opening the eyelids manually, the presence of the conjunctiva was observed bilaterally, the orbits were shallow, and neither orbit contained the eyeball. Further inspection with an ophthalmic clinical flashlight did not reveal any other ocular structures. The initial diagnosis was suggestive of bilateral anophthalmia. Ultrasound examination of the ocular region confirmed the presence of bilateral anophthalmia. A general physical examination revealed a malformed penis with a persistent penile frenulum. Regarding systemic clinical signs (apathy, inappetence, diarrhea, and anemia), clinical and laboratory examinations led to the suspicion of verminosis. Discussion: The dog in this report had a good body score; however, this type of malformation can generate non-viable puppies. Anophthalmia is an extremely rare congenital ocular malformation, both in humans and companion animals, in which there are no ocular structures in the orbits, and these structures (orbits) in affected individuals are generally small and shallow, as seen in the dog in this report. Ultrasonographic examination confirmed the bilateral anophthalmic condition, being the most accurate method of diagnosing this congenital condition. The animal in this report presented with anophthalmia associated with penile malformation. This type of association until this case report has only been described in humans and mice, and is probably caused by a mutation in the SOX2 gene, which is responsible for the protein of the same name, which makes the maturation of ocular tissues in the primitive forebrain. Thus, it is likely that such congenital alterations are the cause of the malformations observed in this animal. Maternal vitamin A deficiency, a factor known to cause ocular malformations, may also be involved in the etiology of congenital diseases. Nutritional imbalances in dogs are common in the animal's region of origin The dog in this report had a normal life. Although it is a condition that causes blindness, dogs can have a normal life and welfare, even with bilateral anophthalmia.

Penectomia em equino com parafimose / Partial penectomy in a horse with paraphimosis

Background: In horses, an increase in the volume of penis and foreskin can be caused by trauma. The resultant edema interferes with the retraction of the penis and cause paraphimosis. Surgical intervention through penectomy is indicated in cases wherein an alternative treatment is not feasible. Partial penectomy can prolong the life and reproductive function of many stallions. The present study aims to report on the methodological, functional, and economic feasibility of a successful case of the use of Williams technique for partial penectomy performed in the field in a horse with paraphimosis, preserving urinary, productive, and reproductive functions. Case: A 10-year-old horse weighing 500 kg had clinical signs of paraphimosis due to the formation of granulomatous tissue following trauma to the glans region. A surgical intervention, namely a partial penectomy was decided to be performed to prevent injury from priapism. Due to the limited resources provided by the owner and the impossibility of moving the animal to a surgical center in a veterinary hospital, the procedure was performed in the field, with prior sanitization and preparation of the environment used to perform surgery. The horse was tranquilized with intravenous xylazine hydrochloride and acepromazine, with subsequent induction of anesthesia with ready-to-use (RTU) guaifenesin bolus and maintenance of anesthesia with an intravenous association of RTU guaifenesin, xylazine hydrochloride, and ketamine. The distal third of the penis was amputated using the recommended Williams technique. Although the complications like dehiscence and emergence of granulation tissue occurred after surgery, these were controlled in the daily follow-up of the animal and post-surgical treatment. Discussion: Paraphimosis predisposed the horse to abrasions and edema of the exposed portion of the penis. However, there was no urine retention, which suggested that the urethral ostium and the urethra had no lesions. Because the granulomatous lesions were located in the distal third of the penis and the extent of penile exposure was small, the partial penectomy technique proved effective in solving the permanent exposure of the penis. The anesthetic protocol used was inexpensive, easy to execute, and effective, and no anesthetic complications occurred, proving this protocol to be efficient for the anesthetic induction of animals in the field. In addition to being reliable and widespread, the Williams technique was recommended to prevent possible urethral stenosis and the development of contact dermatitis by urine. This technique makes a rapid recovery of the animal possible, with improvement of its physiological parameters, and due to ease of being able to be done in the field, it is also inexpensive. The edema and the granulation tissue that occurred after surgery were controlled with medication. In general, post-penectomy animals are not used for reproduction. This makes the present report an important contribution, because in cases in which the lesions present a distal disposition and the penile exposure is small, stallions have a chance of maintaining reproductive function after surgery, even with a long period of evolution before surgical treatment. This was demonstrated in the present case, as the animal in this case later impregnated a mare, with the pregnancy confirmed by ultrasound examination. Partial penectomy is a resolution technique for cases of traumatic paraphimosis, in which exuberant granulation tissue is formed in the distal third of the penis, with a long period of evolution. The surgery can be done in the field, with a low surgical cost to the owner, and a good productive and reproductive prognosis for the animal.

Histomorphometric comparison of the corpus cavernosum of rats submitted to euthanasia with ketamine and xylazine or isoflurane

ABSTRACT Purpose: To compare the penile histoarchitecture of rats euthanized with isoflurane or with ketamine and xylazine. Methods: Fourteen male rats were divided into two groups: ISO, with animals euthanized with isoflurane; and K+X, with animals euthanized with ketamine (150 mg/kg) associated with xylazine (15 mg/kg). Immediately after the death, the penises were dissected, fixed in a 4% buffered formalin solution, and processed for histomorphometric analysis. The surface densities (Sv) of the corpus cavernosum structures (connective tissue, smooth muscle, sinusoidal space, and elastic fibers) were evaluated using Image J software. The distribution of collagen types I and III was qualitatively assessed. Statistical analyses were performed using the Student's t test for data comparison, considering it statistically significant when p < 0.05. Results: Regarding the Sv of connective tissue, smooth muscle and sinusoidal space, there were no differences between animals in both groups. On the other hand, the animals euthanized with the association of ketamine and xylazine showed the Sv of elastic fibers 24.8% higher in relation to animals euthanized with isoflurane. Conclusions: The euthanasia method affected one of the morphological parameters of the rat penises. The choice of euthanasia method must be standardized to reduce bias and to obtain reliable and reproducible results.

Equine coital exanthema caused by equid alphaherpesvirus 3: a report of an outbreak in northeastern Brazil

ABSTRACT: Equine coital exanthema is a venereal infectious disease poorly reported in horses in Brazil and was never described in the northeastern region of the country. This work aims to describe the clinical and pathological aspects of an outbreak of equine coital exanthema caused by equid alphaherpesvirus 3, occurred in a herd of horses at the semiarid region of the State of Rio Grande do Norte. Main clinical signs consisted of anorexia, hiporexia, fibrinous or purulent secretion in the penis mucosa and vagina. Two mares presented mild to minimal lesions that consisted of scars in the mucosa of the vagina and in the perivulvar region. In a stallion the disease consisted of severe, multifocal, umbilicated-exanthematous ulcers of approximately 1cm in diameter on the penis mucosa. Other areas where ulcers and crusts were focally observed included the skin of the scrotum and on the lips and mucocutaneous junctions of the oral cavity. Histologically, the main lesion consisted of multifocal severe ulcerative and fibrinous necrotizing balanoposthitis and mild multifocal necrotizing, lymphocytic dermatitis in the lips and scrotum. The equide alphaherpesvirus 3 DNA was amplified in blood samples and penis mucosa using the PCR technique. This is the first report of molecular diagnosis of equine coital exanthema affecting horses in northeastern Brazil. Further studies should be carried out in order to investigate the epidemiology and the importance of this herpetic disease in the country.

RESUMO: O exantema coital equino é uma doença infecciosa venérea pouco relatada em equinos no Brasil e nunca descrita na região Nordeste do país. Este trabalho tem como objetivo descrever os aspectos clínicos e patológicos de um surto de exantema coital equino causado pelo alphaherpesvirus equídeo 3, que ocorreu em um haras na região semiárida do Estado do Rio Grande do Norte. Os principais sinais clínicos consistiram em anorexia, hiporexia, secreção fibrinosa ou purulenta na mucosa do pênis e vagina. Duas éguas apresentavam lesões discretas que consistiam em cicatrizes na mucosa da vagina e na região perivulvar. Em um garanhão, a doença consistia em úlceras umbilicadas-exantematosas severas, multifocais, de aproximadamente 1 cm de diâmetro na mucosa do pênis. Outras áreas onde úlceras e crostas foram observadas focalmente incluíram a pele do escroto, lábios e junções mucocutâneas da cavidade oral. Histologicamente, as principais lesões consistiam em balanopostite multifocal ulcerativa e necrosante fibrinosa grave e dermatite linfocítica necrosante multifocal leve nos lábios e escroto. O DNA do alphaherpesvirus equídeo tipo 3 foi amplificado em amostras de sangue e mucosa do pênis pela técnica de PCR. Este é o primeiro relato de diagnóstico molecular de exantema coital equino afetando cavalos no nordeste do Brasil. Novos estudos devem ser realizados a fim de investigar a epidemiologia e a importância dessa doença herpética no país.

Parafimose canina recidivante: abordagem cirúrgica modificada / Recurrent canine paraphimosis: modified surgical approach

Background: Paraphimosis is characterized by persistent penile exposure, due to the inability to retract the penis into the prepuce. This persistent exposure of a non-erect penis might result from traumas, infections, neoplasia, anatomic or neurological alterations, or even occur in its idiopathic form. Surgical treatment is indicated when it is not possible to keep the penis covered by the foreskin by trying it manually. The surgical techniques described are efficient in small exposures, however, when these are over 1.5 cm, surgical success might become a challenge. The objective of this study is to report a modified surgical approach to solve a 5 cm recurrent paraphimosis in a dog. Case: A 1-year-old male unneutered mixed-breed dog, weighing 26 kg, was presented for examination with a history persistent paraphimosis background for around 2 months without apparent cause. The animal's tutor reported that it had been submitted to 2 unsuccessful surgical procedures. When the reproductive system was examined, the animal showed a flaccid penis with 5 cm exposure outside the foreskin. A conservative treatment was used, which was also unsuccessful. The next step was a surgical procedure that used the combination of techniques, namely, phallopexy, preputial advancement and reconstruction preputial opening with suture along with orchiectomy. After 10 days, dehiscence of the ostium stitches occurred, which required debridement and new suture. However, it was not efficient and recurrence of the paraphimosis was observed. After 1 month, a new surgery was performed by adapting the phallopexy technique, which was carried out bilaterally and associated to the reconstruction preputial opening with captonated suture, which presented a successful outcome. After 8 months as of the last procedure, the patient is healthy and has no signs of paraphimosis recurrence. Discussion: No consensus has been achieved regarding the paraphimosis treatment, and the resolution of such disorder remains a challenge. For this reason, some parameters should be considered to minimize failure when choosing the surgical technique and, consequently, the recurrence of such condition. Tissue viability, morphological alterations, time of exposure, previous surgeries, and the length of the penis exposure are some of the criteria that must be taken into consideration when choosing the surgical technique. In this case, the first choice was the association of techniques that included preputial advancement, phallopexy and suture preputial opening due to the fact that the exposure was over 1.5 cm and for the existence of a preputial ostium defect, which justified its suture. Despite these associations, paraphimosis recurrence was observed and some of the probable causes include the inadequate position of the penis inside the foreskin flap during the phallopexy and lack of preputial integrity in its ventral aspect. The preputial advancement performed was not sufficient to prevent the exposure or reduce it in the recurrence of the condition, showing that the shortening of preputial muscles and the skin tension might loosen up with time. The second surgery employed bilateral phallopexy without penis exposure to guarantee its correct position, more caudal within the foreskin at the moment of the fixation. The ostium captonated suture also had a relevant role in the tension distribution up to the full tissue healing. New surgical approaches might be needed to achieve success in the paraphimosis treatment. In this report, the length of the penis exposure and the ostium defect were complicating factors. However, the association of the modified surgical techniques resulted in a successful resolution of the condition.