Treatment of Intraoperative Persistent Penile Erection in a Stallion

This case report describes the occurrence of persistent penile erection in a breeding stallion that occurred while the horse was under inhalant anesthesia for a carpal arthroscopy. The horse had no history of breeding problems, and no abnormalities were detected on physical examination, complete blood count, or serum chemistry tests performed prior to surgery. Anesthesia was induced with guaifenesin and ketamine after sedation with xylazine and was maintained with isoflurane in 100% oxygen. Penile erection developed approximately 35 minutes after induction and persisted for over 2 hours despite various physical and pharmacological attempts to alleviate it (massage, cold compresses, intravenous benztropine administration, and intracavernosal phenylephrine). Successful resolution of the erection was obtained by cannulation and drainage of blood from the corpus cavernosum and subsequent irrigation with heparinized sterile saline and infusion of phenylephrine in the corpus cavernosum. The detumescent penis was placed back into the sheath, and purse string sutures were placed in the sheath to ensure the penis would remain inside the sheath during recovery. The stallion's recovery from anesthesia was uneventful, the sutures were removed, and the horse was fitted with a penile sling to prevent additional edema or trauma. The stallion recovered completely from the persistent penile erection. Semen was collected 6 days after the event, and he returned to normal pasture breeding 6 weeks after surgery.