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Following healing of a preputial laceration and when the length of the healthy prepuce is insufficient to allow circumcision, the bull may be returned to breeding soundness with scar revision and preputial reconstruction. Restrain the bull and prepare the prepuce for aseptic surgery. With the penis extended, excise only the superficial transverse scar tissue (Figures 19.40–19.43). Return the edges of the preputial laceration to their original longitudinal orientation. Loosely place an absorbable bootlace suture in a longitudinal plane such that the free ends are toward the sheath (Figure 19.44). Place a 2.5‐cm Penrose drain over the free potion of the penis and revert the penis into the preputial cavity (Figure 19.38). Tighten the sutures to appose the skin edges as you allow the penis to return to within the prepuce (Figure 19.45). You will restrict retraction of the penis if you tighten and tie sutures prior to this.

Figure 19.40 Preputial scar. This scar did not restrict extension of penis, but was painful enough to deter breeding.

Figure 19.41a Scar dissected in transverse plane.

Figure 19.41b Tissue stretched and incised area takes on oval appearance. Closure will be done in longitudinal plane with bootlace suture pattern.

Figure 19.42 Extensive fibrosis. Penis is observed following manual extension.

Figure 19.43 Scar dissected.

Figure 19.44 Closure with bootlace pattern in longitudinal orientation.

Figure 19.45 Schematic of closing incision with bootlace suture pattern when penis returned to retracted position.

The purpose of this procedure is to allow the surgical wound to heal in a longitudinal plane and to maintain normal elastic tissue function. Since no elastic tissue or preputial skin is removed with this procedure, first intention healing should reduce the risk of preputial stenosis and allow subsequent penile extension. Most bulls require 60–120 days for the penis to freely extend following this procedure. Do not forcefully extend the penis during the convalescent period as the potential trauma increases the likelihood of excessive scar formation. Most bulls begin to masturbate within a few weeks following surgery and will stretch contracted tissues without permanent damage.