Perineal Urethrostomy surgery is indicated in male cats that have had a urethral blockage and are not responding to medical therapy. Urethral blockages can be caused by little stones that form in the bladder, by mucous plugs, or by blood clots secondary to bladder inflammation.
Perineal urethrostomy surgery removes the external portion of the penis and urethra, taking the urethra back to the pelvis where it is much wider. The wider diameter of the urethra in this area makes it much less likely that they will become obstructed by small mucous plugs, blood clots, or very small sandy stones.
If a cat is found to have stones, it may require a cystotomy (surgery to remove stones in the bladder) at the same time.
The vast majority of cats do very well after a perineal urethrostomy.
After your cat has a perineal urethrostomy, they will usually be sent home with 2 e-collars. They will usually have a floppy clown collar in addition to a plastic cone. It is extremely important that they not be allowed to lick the area AT ALL. The new opening is created by suturing very delicate urethral mucosa to skin with very tiny sutures. If they lick the site it can scar down and close over requiring another surgery or worse.
The e-collars will need to be worn for 2 weeks.
Cats will have bleeding from the site for one to two weeks after surgery. You may see quite a bit of blood or clots at the site in the first few days. This will gradually decrease and resolve.
Monitor urination carefully. Line the bottom of a litter pan with Yesterday’s News litter. Do not add too much litter or it will be difficult to see the urine clumps.
Long term considerations:
Cats who have had P.U. surgery are a little more prone to urinary tract infections so they should be checked by a vet right away if they show signs of straining, frequency, or blood in the urine.