Perineal Urethrostomy in Cats in Chantilly, VA

Perineal urethrostomy (aka a PU procedure) is a surgical method for alleviating urethral obstruction in cats with complicated or recurrent obstructive feline lower urinary tract disease. While long-term quality of life after perineal urethrostomy in cats with obstructive feline lower urinary tract disease is good (as assessed by owners) and the recurrence rate is low, there are several potential intraoperative and postoperative complications that can occur. The decision to move forward with this procedure should be made after careful consideration of all variables.

What type of patient is best suited for a PU procedure?

A PU procedure is designed to help widen the urethra to make it much less likely (and almost impossible) for a urethral obstruction to occur. Normal male anatomy is such that the urethra gets narrow as it gets to the end of the penis. The opening can be so narrow that even mild inflammation from a UTI or crystals in the urine or even a blood clot can cause a complete obstruction. These cats tend to develop repeated urinary obstructions which then indicates to the veterinary team that widening the urethra could be beneficial. The procedure is a major surgery so we typically don’t recommend it being performed on geriatric patients, but each patient should be assessed individually to make that determination.

What are the complications associated with this procedure?

The most common complications are swelling, bleeding at the surgical site, and urine leakage into the subcutaneous tissues around the surgical site. These are oftentimes minimal issues and are resolved by the time your pet is discharged from the hospital. More serious complications include urinary incontinence, fecal incontinence, stricturing of the surgical site, intra-pelvic strictures not resolved by the PU surgery, surgical site dehiscence and infection, and failure of the site to fully heal requiring revision. While these complications are not common, they can be serious and require additional surgery or lifelong medical management at home.

When my cat comes home, what precautions should I take and will he be able to live a normal life again?

After the initial 2-week recovery period your feline friend should be able to return to normal activities. The first 2 weeks are crucial for recovery and it is best to keep him away from other cats and dogs who could lick his incision line to “clean it” and also limit his activity to help ensure the incision heals appropriately. There is only one thin layer of sutures holding the incision line together so even minimal licking or excessive jumping can disrupt the sutures, tear the tissue, and cause strictures of the site.

What preparations do I need to make at home before my cat comes home after surgery?

We recommend that cats use a paper litter for the first week after surgery. The pelleted paper litters such as Yesterday’s News are available at most grocery stores and pet stores. We also recommend having an area such as a small bedroom or bathroom where your cat can stay with his food, water, and litter box. This will be the best place for him to recover for the first 7-14 days, or however long he will tolerate being cooped up in there.

Has your cat struggled with recurrent urethral obstructions? Contact our team to learn more about perineal urethrostomy surgery!

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