Urethrostomy in Cats-Another Approach

Eleven cats that were candidates for perineal urethrostomy were entered into a prospective study evaluating the feasibility and long-term outcome of a modified subpubic urethrostomy technique called transpelvic urethrostomy. In this procedure, the penis is exposed, extended caudally, and denuded, and a 12- × 15-mm area of ischium is removed. The pelvic urethra is incised and sutured to the skin to create a urethrostomy. All cats having this procedure recovered without complications and were followed for 9 to 42 months. A stricture was noted in 1 cat as defined by the inability to pass a 6-French catheter; however, the cat was asymptomatic. One cat had postoperative urinary incontinence that resolved within 4 weeks. Two cats had lower urinary tract disease that responded to medical therapy during the initial 6-month follow-up.

COMMENTARY: With the advances in dietary management of obstructive lower urinary tract disease, fewer and fewer perineal urethrostomies are being performed. This is fortunate because of the well-known perineal urethrostomy complications, of which postoperative stricture is the most common. The advantage of transpelvic urethrostomy is that it involves the pelvic urethra, which is much wider (2 to 2.2 mm) than the penile urethra (0.7 mm). One potential complication described in the study was intermittent urine staining of the feet and abdomen that depended somewhat on body stance during micturition.

Transpelvic urethrostomy in 11 cats using an ischial ostectomy. Bernade A, Viguier E. VET SURG 33:246-252, 2004.