Reefing (Segmental Posthetomy) in Bulls: Surgical Technique for Preputial Resection

Reefing is also known as segmental posthetomy or circumcision, surgery is performed under general anesthesia. This technique is employed to revise damaged preputial tissues.

Reefing (segmental posthetomy) in bulls is a surgical procedure used to remove damaged or diseased sections of the prepuce (the sheath of skin covering the penis).

Indication

It is commonly performed in bulls that have sustained preputial injuries, such as lacerations, infections, or scar tissue that interfere with normal extension of the penis during breeding.

Surgical Procedure

A penrose drain tourniquet is tied near the preputial orifice and towel clamps are placed under the dorsal apical ligament to allow extension of the penis and prepuce during surgery.

The site is surgically prepared and aseptic technique is utilized. Two circumferential incisions are made a sufficient distance apart to excise the affected tissues.

The prepuce is measured prior to incision to assure that the final preputial length will be at least twice (2X) the length of the free portion of the penis.

The circumferential incisions are connected by a longitudinal incision and the affected portion of prepuce is sharply dissected from the underlying elastic tissues.

Dissection should be as superficial as possible but as deep as necessary in the areas of scar tissue formation.

Hemostasis is important and after completion of dissection the tourniquet is removed and every effort is made to control hemorrhage to prevent subsequent hematoma/seroma formation.

After removing the segment of integument, the remaining prepuce should be at least 1.5 times the segment of the free portion of the penis to allow the bull to be able fully extend its penis.

The tourniquet is then removed and vessels ligated. A penrose drain is sutured over the free end of the penis to prevent urine contamination during healing.

The penis is allowed to return to the preputial cavity and a sterile soft rubber tube (with the penrose threaded through its lumen) is bandaged in place to retain the prepuce during healing.

Subcutaneous tissue at the circumferential incisions is apposed with 4 simple interrupted sutures of 2-0 absorbable suture.

The preputial integument is sutured with the same suture in an interrupted horizontal mattress pattern.

The penis and prepuce are replaced into the preputial cavity and retained as described on management of preputial injuries.

Post Operative Care

The bandage is removed after 3 to 4 days, and the bull is administered antimicrobial therapy for 1 week.

Bulls undergo sexual rest for 8 weeks and examined before allowing resuming natural breeding.