Urethrostomy done using the anastomosis technique of the prepuce mucosa to the pelvic urethra in cats with penile urethral obstruction

Abstract

Penile urethral obstruction in cats is a commonly seen clinical manifestation. In cases where there is no response to catheterisation and medical intervention, surgery is needed to provide urination and correct uremia and hyperkalemia. Several surgical techniques have been described. The perineal urethrostomy technique, reported by Wilson and Harrison in 1971, has been used extensively and since then various modifications of this technique have been developed by other researchers. In 2000, Yeh and Chin described a modified perineal urethrostomy tech­nique created by use of the prepuce mucosa. This technique was used in our clinic in 20 cats with penile urethral obstruction. Seventeen cats recovered without complication. A 2.6 mm diameter catheter was placed in each of the 3 cases in which leakage was determined in the anastomosis site. The urine gathered in the site subcutaneously was drained. Normal urination was achieved in 2 of the 3 patients treated with this technique. The remaining case was re-operated and the perineal urethrostomy technique, in which the urethra was sutured to the perineal skin (the Wilson and Harrison method, 1971), was applied. The advantages of this technique over the classical perineal urethrostomy technique are; return to urination shortly after the operation, better urination potential compared to normal cats, a more aesthetic appearance compared to other techniques (similar to a castrated cat), no narrowing of the orifice caused by re-growth of hair. It was also understood that, anastomosis of the urethra and the prepuce mucosa must be carried out with utmost care in order to prevent urine leakage.