Vet Clin Food Anim 24 (2008) 253–266

Surgery of the Scrotum

Jennifer M. Ewoldt, DVM, MS
Scott County Animal Hospital, 115 South 16th Avenue, Eldridge, IA 52748, USA

Scrotal surgery is common in routine veterinary practice. Many tech-

niques are available for commonly performed surgeries, and most can easily
be accomplished in private practice and in the field. Procedures are
described for surgical and nonsurgical castration, unilateral castration,
inguinal herniorrhaphy, cryptorchidectomy, caudal epididymectomy, and
vasectomy. Changes in current thinking about the timing of castration
and about pain control in cattle surgery will likely alter the way veterinar-
ians perform scrotal surgery in the years to come.

Castration (orchiectomy)
Castration is the most common scrotal surgery, performed thousands of
times each month. Castration of male calves is often performed at birth, at
branding in the west, or at weaning. Late castration may also be performed,
but is considered to be more stressful to the bull because of scrotal and tes-
ticular size. Postsurgical complications are also more common at later ages.
Males are castrated to reduce sexual activity in the feedlot stage, and to pre-
vent reproduction of inferior animals.
There are a number of methods to castrate calves. Surgical castration is
preferred because one can be ensured that both testicles have been removed.
Castration is most commonly performed in lateral recumbency in small
calves, or in a squeeze chute in larger calves and bulls. Traditionally, castra-
tion has been performed without the use of analgesia, although current think-
ing on this as a welfare issue is bringing about change in this arena. When
castrating a large number of calves, the provision of analgesia is often incon-
venient and expensive, but the benefit to calves during and after surgery may
be important in promoting continued feed consumption and rate of gain.
To perform castration, the testicles must first be exposed. If two testicles
are not palpable in the scrotum, the animal must be considered a cryptorchid

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254 EWOLDT

and the cryptorchid testicle should be removed first (see later discussion on
cryptorchidism). Two methods have been commonly used. In the first, used
most commonly in small calves, the bottom one third to one half of the scro-
tum is amputated using a scalpel. The testicles then drop into view. This
method provides excellent postcastration drainage. In the second method,
separate incisions are made over each testicle, either laterally, or caudally.
This is most easily accomplished by use of a Newberry knife, which is
inserted from side to side across the scrotum after pushing the testicles prox-
imally with the other hand. The Newberry knife can also be used in a cra-
nial-to-caudal fashion, opening each side of the scrotum separately. The
side-to-side incision allows for significantly more drainage postsurgery,
which prevents postoperative swelling and establishment of infection.
The simplest method of castration is performed in very small calves,
where slow traction is placed on the testicle until spontaneous rupture of
the cord occurs. This closes the spermatic vessels and prevents bleeding. It
can, however, lead to the occurrence of ‘‘gut-tie’’ and intestinal obstruction
later in life as the retracting ends of the spermatic cords snap back into the
abdomen and may adhere to anything in the abdomen, including the intes-
tine [1]. As a result, sharp transection of the spermatic cords is always
preferred.
Even when sharp transection of the cords is performed, castration in cat-
tle is normally performed as a closed castration, without opening the tunica
vaginalis. Following exposure of the testicles, the adherent adipose tissue
and connective tissue is ‘‘stripped’’ proximally to allow for good exposure
of the cords. An emasculator (White, Serra, Frank, Reimer, or Hausmann)
is placed around the cord as proximally as possible, and closed tightly. Ten-
sion should be released on the cords when the emasculator is applied [2].
Maintaining pressure for approximately 30 to 45 seconds is usually sufficient
to promote hemostasis in the transected vessels. In very small calves, both
cords can be emasculated at the same time. In large bulls, it may be desirable
to open the tunica vaginalis and emasculate the retractor muscle and the
vascular cord separately. Sufficient tunica should still be removed to prevent
hydrocoele formation if this technique is used. Following castration, any
tissue hanging from the scrotum should be removed by traction or with
emasculator or scalpel.
If desired, the spermatic cord can be ligated with monofilament absorb-
able suture rather than leaving the cord open. A ligature is applied around
the cord as proximally as possible and as tightly as possible. The cord can
then be cut sharply or emasculated distal to the ligature. This reduces the
amount of postoperative hemorrhage, but may increase the chances of post-
operative infection because a foreign object is present, which may harbor
bacteria. If ligatures are required or desired, close attention must be paid
to aseptic technique. Ligatures can also be applied to large bull cords where
hemorrhage is more likely or to cords that continue to hemorrhage exces-
sively following castration by any other means.
 SURGERY OF THE SCROTUM 255

A fairly recent addition to the veterinarian’s toolbox popular in some

parts of the country is the Henderson castration tool, developed by Lance
Henderson and manufactured by Stone Manufacturing and Supply
Company (Kansas City, Missouri). This specialized clamp is inserted into
a variable-speed battery-powered drill, and is used to castrate calves with
a significantly reduced risk of hemorrhage. Following exposure and strip-
ping of the cords, the clamp is placed proximal to the testicle, and the drill
is activated, producing a slow twisting action, which eventually causes the
tunica vaginalis to twist closed and separate in the region of the inguinal
ring. This removes the testicle, and provides hemostasis at the same time.
The author has used this tool on animals up to 1200 pounds, but it is easiest
to use on smaller calves. If rotation is performed too quickly, it is possible
for the testicle to be removed before hemostasis is achieved. In theory, ‘‘gut-
tie’’ could occur with this technique also, because the exposed end of the
cord may be within the abdomen. Those interested in the tool are encour-
aged to purchase the newer version, which has teeth in the clamp to provide
better grip on larger spermatic cords.
The Burdizzo emasculatome provides bloodless castration by means of
crushing the spermatic cord through the scrotal skin. The spermatic cord
is pushed to the lateral aspect of the scrotal neck, and the emasculatome
is applied across the cord. Some sources suggest crushing each cord twice
to ensure complete disruption of the blood supply [3]. Others suggest manip-
ulating the cord while clamped, to separate it from the other half of the cord
[4]. The testicles are then left in situ to atrophy. It is important not to disrupt
the blood supply to the scrotum itself by applying the emasculatome across
the median raphe of the scrotum.
Nonsurgical castration can be performed with the use of rubber rings or
bands and an elastrator tool. These may be applied at any time during the
life of the animal from birth. Application of these bands causes ischemic
necrosis of the scrotum and testicles, eventually resulting in sloughing of
the scrotum and contents. Elastrator bands are not as popular in cattle as
they are in sheep, but are preferred by some producers. The new Callicrate
bander system (No Bull Enterprises, St. Francis, Kansas) uses rubber strips
that are applied around the scrotum and crimped with a special banding
tool. This system claims to be useful in all ages of bulls. Proponents of
the Callicrate system claim growth benefits from retention of the endoge-
nous testosterone, and no daily gain loss at the time of castration compared
with surgical castration. Recent reports, however, showed significant loss of
gain following banding with this tool [5,6]. The use of elastrator bands in
calves can result in tetanus because of the presence of necrotic tissue, and
precautions must be taken to avoid problems. There is also some question
as to the pain involved in the use of these bands, because necrosis takes
several weeks to occur [5,6]. The most critical problem with the use of elas-
trator bands and rings is their correct application. The applicator must
ensure that both testicles are within the scrotum at the time of application,
256 EWOLDT

and that no other organs (eg, intestine) are present in the scrotum. Incorrect
application of the bands may result in partial castration, or intestinal
obstruction.
Complications may occur following castration by any means. Calves
should be observed for excessive hemorrhage, which may require attention
in the form of ligatures, clamps, or packing. Fatal hemorrhage is rare, but
can occur with significant hemorrhage from the testicular artery. Postcastra-
tion swelling is reduced by encouraging free exercise and drainage. If swelling
is severe, antibiotics and anti-inflammatory drugs should be administered,
and drainage established if possible. Infection at the castration site may ne-
cessitate resection of infected tissues, and certainly requires the use of antibi-
otics to prevent toxemia. Clostridial vaccination should be performed at the
time of castration, if not already administered, and many veterinarians also
give prophylactic procaine penicillin G at the time of castration. Close atten-
tion should be paid to calves with elastrator bands, to ensure that the necrotic
scrotum falls off quickly, and that the calves are showing no signs of tetanus
or local infection. Elastrator bands have the additional risk of incorrect
application, as mentioned previously.
Although rare, evisceration can occur following any open castration pro-
cedure. It may be more common in bulls with large inguinal rings, in older
bulls, and in bulls with inguinal hernia. Evisceration is often a fatal compli-
cation, but immediate detection and rapid surgical correction can result in
good outcomes. Also considered a complication is failure to recognize crypt-
orchidism, and subsequent removal of only one testicle. Inguinal hernias can
be mistaken as a scrotal testicle, and opening of these may cause inadvertent
incision of the intestine. It is also possible to mistake the penis for the testicle
and incise it, causing penile amputation or urethral fistula. The penis can be
incorrectly included in the emasculatome, which causes urethral obstruction
and penile necrosis.
Management of pain in calves undergoing castration is becoming more
and more of a welfare issue for veterinarians. Recent research has examined
pain responses of calves following castration by various methods, and fol-
lowing various local and systemic analgesics. It is hoped that an effective
and economic method of providing pain control for calves will be deter-
mined from this research. Using serum cortisol as a measurement of stress,
Stafford and colleagues [7] showed that local anesthesia alone did not pre-
vent cortisol increase, but the addition of an nonsteroidal anti-inflammatory
drugs did reduce cortisol release following castration by various techniques.
Ketoprofen administration also reduced plasma cortisol response in calves
following surgical castration [8]. Local anesthesia reduced the cortisol
response following castration, but this response was only present as long
as there was local anesthetic present. Following metabolism of the local an-
esthetic, cortisol increased and pain activities increased [9]. The administra-
tion of sodium salicylate before castration in calves reduced the cortisol
response; however, cortisol concentrations rose rapidly following reduction
 SURGERY OF THE SCROTUM 257

in the serum salicylate level [10]. Plasma cortisol levels were increased in
both calves castrated surgically and with a Burdizzo emasculatome, but
the administration of local anesthetic attenuated the cortisol increase [11].
Castration by rubber ring (elastrator band) produced prolonged pain
responses in calves [12]. From this research, it seems that all methods of
castration induce a stress response and pain response, and that nonsteroidal
anti-inflammatory drugs are effective in controlling this response over long-
term, whereas local anesthesia is effective only temporarily.
The timing of castration of bulls varies with location, production system,
and individual. Although the cattle industry in general has considered early
castration to be easier on calves than late castration, there are little data to
prove these theories. Some recent research has provided hard data regarding
timing of castration and effects on average daily gain and pain responses.
With regards to age at castration, castration-associated weight loss increases
quadratically with age, and castration performed after puberty had signifi-
cant negative effect on average daily gain [13]. Stress response also seemed
to be lower in cattle castrated at less than 6 months of age, as measured
by cortisol response [13]. It seems that early castration is indeed better for
the calves than late castration. With regards to the method of castration,
the data are less clear. Stafford and colleagues [7] and Thüer and colleagues
[12] showed that the initial stress response is less with banding techniques,
but that chronic pain responses may be present following banding. Bulls
banded at weaning with the Callicrate bander gained less that bulls banded
or surgically castrated at 2 to 3 months of age [14]. Use of the Callicrate
bander at weaning actually reduced postcastration average daily gain com-
pared with surgically castrated bulls in a study by Knight and colleagues [5].
Banded bulls also grew more slowly in a second study by Fisher and col-
leagues [6], and animals suffered from chronic scrotal wounds.

Unilateral castration
Unilateral castration (orchiectomy) is the removal of one testicle while
leaving the opposite testicle in place. It can be performed for many reasons,
including testicular injury, hydrocoele, testicular abscess, inguinal hernia,
testicular neoplasia, incomplete prior castration, orchitis, or other testicular
or epididymal abnormalities (Figs. 1–4) [15–17]. Medical treatment is often
first attempted, including hydrotherapy, antibiotics, and anti-inflammatory
drugs. Delay in surgical removal of a diseased testicle may result in damage
to the contralateral testicle, however, by the heat and swelling associated with
scrotal disease [16]. Prior to attempting this surgery, it is essential that the
contralateral testicle be evaluated thoroughly with palpation, ultrasound,
or other diagnostic modalities to detect any concurrent abnormalities. If
the contralateral testicle is not functional, unilateral orchiectomy is pointless.
Unilateral castration can be performed in lateral recumbency under general
anesthesia or heavy sedation, or may be performed as a standing procedure in
258 EWOLDT

Fig. 1. Unilateral hydrocoele in a bull demonstrating the asymmetric enlargement of scrotum.

squeeze chute with epidural and local anesthesia [15,17,18]. The procedure is
similar to routine castration of an older bull. A vertical incision is made at the
proximal-lateral aspect of the scrotum over the abnormal testicle and sper-
matic cord. The spermatic cord and testicle (within the tunica vaginalis) are
freed from any underlying tissue. At this time, the surgeon must decide
whether to ligate the entire spermatic cord (closed castration), or to open
the tunica vaginalis and ligate vascular and muscular components separately.
In general, open ligation is suggested to reduce any possibility of hemorrhage.
Double ligation is suggested to prevent postoperative hemorrhage. The tes-
ticle, tunica, and spermatic cord are removed distal to the ligature using an
emasculator. Closure of the tunica over the vascular stump has been described,
but is not possible in all cases [16,18,19]. If unilateral castration is being

Fig. 2. Asymmetric enlargement of scrotum in a bull with unilateral scrotal abscess.

 SURGERY OF THE SCROTUM 259

Fig. 3. Periorchitis in a testicle resulting in fibrin and fluid accumulation around the testicle.

performed because of inguinal herniation, the inguinal ring must be closed to

prevent further herniation of abdominal contents. The skin and subcutaneous
tissues (tunica dartos) are closed in two layers, unless there is infection requir-
ing open drainage. The empty scrotum can be packed with roll gauze and the
end of gauze left protruding through an open ventral aspect of the incision.
The packing is removed at a later time. If complete closure of the incision is
performed, place two to three interrupted sutures at the distal aspect of the
incision should drainage be desired postoperatively. In most cases, it is neces-
sary to remove some of the lateral scrotal skin to reduce dead space, or to
remove pathology. Postoperatively scrotal swelling is common, occurring in
approximately 70% of bulls, but can be managed with hydrotherapy and
anti-inflammatory drugs [15].

Fig. 4. Testicular rupture resulting in hemorrhage into the scrotum.

260 EWOLDT

Unilateral orchiectomy can preserve the breeding function of bulls

[15–18]. Thirteen of 15 bulls became productive and fertile within 6 months
of unilateral orchiectomy [15], and five of eight bulls became fertile within
12 months of surgery [17]. Wolfe and coworkers [18] reported that normal
bulls produced normal semen within 3 weeks of unilateral castration, but
suggested that the heat and swelling associated with conditions necessitating
unilateral castration may prolong this period in affected animals. It is com-
monly reported that the remaining testicle may hypertrophy and produce
approximately 75% of the normal semen volume [16,17].

Cryptorchidism
Cryptorchidism occurs when one or both testicles fail to descend into the
scrotal sac from their abdominal origin. The testicle may be located within
the abdomen; within the inguinal canal; or subcutaneously outside the scro-
tum (called ectopic testicle). Cryptorchidism is uncommon in cattle, with
most cryptorchid testicles actually being ectopic (located in the subcutane-
ous tissues in the inguinal or preputial area). Cattle are most likely to
have unilateral cryptorchidism (usually the left), and usually inguinal rather
than abdominal [3,19].
Removal of a cryptorchid testicle depends on its location. Ectopic tes-
ticles can be removed with the animal restrained in dorsal or lateral recum-
bency, with sedation or general anesthesia. Ligation of the cord with
monofilament absorbable suture is recommended, and the incision may be
closed if performed aseptically, or left open for drainage if performed in
the field. Inguinal testicles are best removed with the animal in dorsal
recumbency under general anesthesia, and prepared for aseptic surgery.
The incision is made over the palpable testicle, or near the inguinal ring.
Once the testicle or spermatic cord is identified, the cord is ligated with
absorbable monofilament and the testicle removed with scalpel or emascu-
lators distal to the ligature. The incision is closed routinely in two layers.
Abdominal testicles are removed under general anesthesia by flank
incision with the animal in lateral recumbency, or by parainguinal incision
with the animal in dorsal recumbency (as for a tube cystostomy). The inci-
sion is made on the side with the retained testicle. Locating the intra-
abdominal testicle can be difficult, and the entire abdomen must be explored
from inguinal ring to kidney. Exteriorization of abdominal testicles can also
be difficult (Fig. 5). Once located, the spermatic cord is ligated as previously
described, and the testicle removed. Use of an emasculator only without
ligation has been described, but this author prefers ligation to prevent
intra-abdominal hemorrhage. Abdominal testicles are normally much
smaller than their normal counterparts, and one must be sure to remove
the entire testicle and epididymis, which is not closely attached to the testicle
as in the scrotum.
 SURGERY OF THE SCROTUM 261

Fig. 5. Limited exposure of intra-abdominal cryptorchid testicle by parainguinal approach

(Courtesy of Matt D. Miesner, DVM, MS, Manhattan, KS.)

Inguinal hernia
Inguinal hernia results in the herniation of abdominal contents (usually
omentum or jejunum) through the internal inguinal ring. If this continues,
scrotal hernia results as inguinal hernia contents move through the external
inguinal ring into the scrotum. Inguinal hernia results in enlargement of the
neck of the scrotum or obvious enlargement of the scrotum itself (Fig. 6) [3].
Inguinal hernias are common in cattle, and may be congenital or acquired.
Congenital hernias are usually hereditary, are seen in cattle less than
12 months of age, and occur because of large inguinal rings. The author
has seen these mainly in Herefords and Hereford cross cattle.
Acquired inguinal hernia occurs in adult bulls following trauma, or
because of age-related relaxation and stretching of the abdominal muscula-
ture [3]. Most inguinal hernias occur on the left side. It is speculated that this
occurs because of the normal sternal position of cattle with the right hind leg

Fig. 6. Inguinal hernia in a bull. Note the loss of the normal scrotal neck.
262 EWOLDT

under the body and the left hind leg extended [3]. This position promotes
eructation and regurgitation, but stretches the left inguinal ring open.
Diagnosis of inguinal hernia requires careful palpation of the scrotum,
rectal palpation, and often ultrasonography. Herniation is often painful
for the bull, and gastrointestinal obstruction or hind limb problems may
be initially suspected. Hydrocoele, orchitis, epididymitis, inguinal fat, peri-
orchitis, and neoplasia may all resemble an inguinal hernia. Inguinal hernia
may result in swelling of the scrotal neck; the testicle itself (because of
venous congestion); or enlargement of the entire scrotum. A hernia may
be initially manually reducible, but if the hernia is present for sufficient
time to cause irritation, adhesions may occur between the tunica vaginalis
and the herniated tissues.
Surgical correction of inguinal and scrotal hernias should be attempted as
soon as possible to prevent damage to the affected testicle and damage to the
contralateral testicle by swelling and heat. Surgery is best performed under
general anesthesia in lateral or dorsal recumbency with the hind end some-
what elevated. If strangulated intestine is not present, withholding feed and
water for 24 to 48 hours before surgery helps reduce the abdominal size. The
skin incision is made over the external inguinal ring near the base of the
scrotum [3]. Blunt dissection is used to locate the external inguinal ring
and vaginal tunic. The hernia is reduced manually if possible by pressure
or by twisting the testicle and spermatic cord to return the hernia contents
to the abdomen [19]. If the hernia cannot be reduced, the tunic is opened
and the hernia reduced manually. Adhesions are bluntly separated if neces-
sary. Intestine is resected only if obviously devitalized, and devitalized
omentum can be resected if desired. Following reduction of the hernia,
the tunic is closed with absorbable suture in a continuous pattern. The
internal and external inguinal rings must then be closed using preplaced
interrupted sutures of heavy nonabsorbable suture material in the cranial
aspect of the rings. It is recommended that there be enough space remaining
for the spermatic cord and one finger to pass through. Closure is simplified if
unilateral orchiectomy is performed at the same time. This allows complete
closure of the inguinal opening. The subcutaneous tissues are closed using
absorbable suture material, and the skin closed routinely with nonabsorb-
able suture material. Postoperative antibiotics and anti-inflammatory drugs
are used for several days after surgery. Hydrotherapy is helpful in prevent-
ing and reducing postoperative swelling. Sexual rest is recommended for
3 months after surgery [3].
Hernia correction by flank incision in a standing animal has also been
described, but may be difficult or impossible if adhesions are present [3].
With this technique, the internal inguinal ring is closed blindly within the
abdomen.
Regardless of technique used, it is important to remember that herniation
can recur in any animal that does not undergo unilateral orchiectomy and
complete closure of the inguinal ring. It is also possible for the testicle to
 SURGERY OF THE SCROTUM 263

be damaged or devitalized, requiring unilateral orchiectomy at a later date.

Congenital inguinal hernia correction should only be performed with bilat-
eral castration because this is considered a hereditary defect.

Epididymectomy
Caudal epididymectomy is an easy field technique used to create teaser
bulls for estrus detection. This technique prevents fertilization, but does
not prevent intromission, so disease transmission can still occur; however,
libido and natural behaviors are preserved.
Epididymectomy is performed in a standing bull in a squeeze chute. The
distal scrotum is clipped and prepared for surgery. Anesthesia is provided by
local infiltration anesthetic or caudal epidural, or a combination of the two.
Push the testicles into the scrotum by applying pressure to the neck of the
scrotum. A small (1-in) incision is made over the caudal epididymis (identi-
fied as a bulge on the distal testicle). The incision is continued through the
parietal tunic until the epididymis is visible at the incision. It is helpful to
maintain downward pressure on the testicle within the scrotum to simplify
identification of the epididymis because it protrudes from the incision.
The epididymis is then grasped with a hemostat or towel forceps. Traction
is applied to exteriorize the entire caudal tail of the epididymis. Hemostatic
forceps are then placed across each arm of the epididymis (Fig. 7), and the
epididymis is excised with scissors or scalpel. Care must be taken to avoid
incising the tunica vaginalis of the testicle, because hemorrhage results. If
this occurs, suture closure of the tunic is required. The procedure is repeated
on the second epididymis. Closure of the incisions is not required [20,21]. It
is recommended that the excised tissue be examined to ensure that the entire
epididymis has been removed, and that no section remains that could recan-
alize and restore fertility.

Fig. 7. Epididymectomy in a bull demonstrating the exteriorized and clamped epididymis

immediately before excision.
264 EWOLDT

Providing that the entire epididymis has been removed, success rates are
near 100% with this technique. Occasional local infection can be managed
with antibiotics and hydrotherapy. Tetanus may be a problem in some areas,
and prophylactic penicillin or clostridial vaccination may be necessary. The
author is aware of a few reports of granuloma formation at the epididymec-
tomy site, but these did not interfere with the function as a teaser bull.

Vasectomy
Bilateral vasectomy also can be used to create infertile teaser bulls. This
technique also prevents fertilization, but allows intromission. There is still
a risk of disease transmission.
Vasectomy can be performed with the bull standing in a squeeze chute;
however, ventral abdominal support is recommended in case the patient
should go down during surgery. If performed in lateral recumbency (pre-
ferred by the author), the bull is placed in lateral recumbency with the upper
leg drawn somewhat caudally to expose the scrotum. This technique is best
performed with the bull under general anesthesia to prevent motion, but
can be performed under heavy sedation with local anesthetic infiltrated in
the area of the incision. The neck of the scrotum is clipped and aseptically
prepared for surgery. A 1- to 2-in vertical incision is made over the neck of
the scrotum just above the testicle. The author prefers to make an approach
on the cranial aspect of the neck, although there are reports of approaching
the spermatic cord from the cranial, caudal, and lateral aspects [19]. The in-
cision is extended through the skin and tunica dartos until the spermatic cord
is visible. A finger or forceps is then used to exteriorize and stabilize the sper-
matic cord at the incision. A 1-in incision is then made carefully through the
tunica vaginalis to expose the spermatic cord components [20]. The cremaster
muscle must be avoided in this process, and the vascular tunic opened
instead. Identify the ductus deferens within the vaginal tunic. It appears as
a light-colored firm tubular structure approximately 2 to 3 mm in diameter.
The ductus lies within a separate fold of the visceral tunic called the ‘‘meso-
ductus deferens,’’ which can assist in identification. Place a proximal and dis-
tal ligature of absorbable monofilament approximately 2 in apart around the
ductus. After placing the two ligatures, the ligated segment of ductus is ex-
cised. Close the tunica vaginalis, tunica dartos, and skin routinely. An alter-
native approach useful in small ruminants has been described [22]. The
author has no experience with this technique, or knowledge of its use in cattle.
It is essential to confirm that the ductus deferens has been identified and
ligated, so extreme care must be taken during surgery to identify the testic-
ular artery and vein before placement of ligatures [20]. After surgery, the
author has retained the segments of ductus deferens in labeled jars of forma-
lin to confirm by histopathology that the correct structure was removed, if
ever a question should arise. If the correct structure is ligated and excised,
100% success is attained. Infection at the incision site is rare. Poor surgical
 SURGERY OF THE SCROTUM 265

technique resulting in damage to the testicular artery or vein can result in

local hemorrhage and hematoma formation or reduced blood supply to
the testicle.

Summary
Scrotal surgery is common in routine veterinary practice. Many tech-
niques are available for the commonly performed surgeries, and most can
easily be accomplished in private practice and in the field. Changes in cur-
rent thinking about the timing of castration and about pain control in cattle
surgery will likely alter the way veterinarians perform scrotal surgery in the
years to come.

References
[1] Wolfe DF, Mysinger PW, Carson RL, et al. Incarceration of segments of the small intestine
by remnants of the ductus deferens in steers. J Am Vet Med Assoc 1987;191:1597–8.
[2] Turner AS, McIlwraith CW. Calf castration. In: Turner AS, McIlwraith CW, editors. Tech-
niques of large animal surgery. 2nd edition. Philadelphia: Lea & Febiger; 1989. p. 289–90.
[3] St Jean G. Male reproductive surgery. Vet Clin North Am Food Anim Pract 1995;11:55–94.
[4] Baird AN, Wolfe DF. Castration of the normal male. In: Wolfe DF, Moll HD, editors. Large
animal urogenital surgery. 2nd edition. Baltimore (MD): Williams and Wilkins; 1999.
p. 295–312.
[5] Knight TW, Cosgrove GP, Death AF, et al. Effect of method of castrating bulls on their
growth rate and liveweight. New Zealand Journal of Agricultural Research 2000;43:187–92.
[6] Fisher AD, Knight TW, Cosgrove GP, et al. Effects of surgical or banding castration on
stress responses and behaviour of bulls. Aust Vet J 2001;79:279–84.
[7] Stafford KJ, Mellor DJ, Todd SE, et al. Effects of local anesthesia or local anaesthesia plus
a non-steroidal anti-inflammatory drug on the acute cortisol response of calves to five differ-
ent methods of castration. Res Vet Sci 2002;73:61–70.
[8] Ting ST, Earley B, Crowe MA. Effect of repeated ketoprofen administration during surgical
castration of bulls on cortisol, immunological function, feed intake, growth, and behavior.
J Anim Sci 2003;81:1253–64.
[9] Mellor DJ, Stafford KJ, Todd SE, et al. A comparison of catecholamine and cortisol
responses of young lambs and calves to painful husbandry procedures. Aust Vet J 2002;
80:228–33.
[10] Coetzee JF, Gehring R, Bettenhausen AC, et al. Attenuation of acute plasma cortisol
response in calves following intravenous sodium salicylate administration prior to castra-
tion. J Vet Pharmacol Ther 2007;30:305–13.
[11] Fisher AD, Crowe MA, Alonso de la Varga ME, et al. Effect of castration method and the
provision of local anesthesia on plasma cortisol, scrotal circumference, growth, and feed
intake of bull calves. J Anim Sci 1996;74:2336–43.
[12] Thüer S, Mellema S, Doherr MG, et al. Effect of local anesthesia on short- and long-term
pain induced by two bloodless castration methods in calves. Vet J 2007;173:333–42.
[13] Bretschneider G. Effects of age and method of castration on performance and stress response
of beef male cattle: a review. Livest Prod Sci 2005;97:89–100.
[14] Lents CA, White FJ, Floyd LN, et al. Method and timing of castration influences perfor-
mance of bull calves. 2001 Animal Science Research Report, Oklahoma State University;
2001.
266 EWOLDT

[15] Ivany JM, Anderson DE, Ayars WH, et al. Diagnosis, surgical treatment, and performance
after unilateral castration in breeding bulls: 21 cases (1989–1999). J Am Vet Med Assoc 2002;
220:1198–202.
[16] Wolfe DF. Unilateral castration for acquired conditions of the scrotum. In: Wolfe DF, Moll
HD, editors. Large animal urogenital surgery. 2nd edition. Baltimore (MD): Williams and
Wilkins; 1999. p. 313–20.
[17] Heath AM, Baird AN, Wolfe DF. Unilateral orchiectomy in bulls: a review of eight cases.
Vet Med 1996;8:786–92.
[18] Wolfe DF, Hudson RS, Carson RL, et al. Effect of unilateral orchiectomy on semen quality
in bulls. J Am Vet Med Assoc 1985;186:1291–3.
[19] Gilbert RO, Fubini SL. Surgery of the male reproductive tract. In: Fubini SL, Ducharme
NG, editors. Farm animal surgery. St. Louis (MO): Saunders; 2004. p. 351–79.
[20] Wolfe DF. Surgical preparation of estrus-detector males. In: Wolfe DF, Moll HD, editors.
Large animal urogenital surgery. 2nd edition. Baltimore (MD): Williams and Wilkins; 1999.
p. 327–33.
[21] Gill MS. Surgical techniques for the preparation of teaser bulls. Vet Clin North Am Food
Anim Pract 1995;11:123–36.
[22] Lofstedt RM. Vasectomy in ruminants: a cranial midscrotal approach. J Am Vet Med Assoc
1996;181:373–5.