Urethrostomy

Urethral obstruction is an often acute and life-threatening condition caused by impaired urine flow from the bladder. The main causes of obstruction are uroliths, which are urinary stones that can block the urethral passage like a plug. Urinary stones can form in either the kidneys or the bladder. Unlike in humans, in dogs and cats uroliths are much more likely to form in the bladder rather than the kidneys. Male cats and dogs (especially small breed dogs) are much more prone to urethral obstructions. This is due to the fact that in males the urethra is divided anatomically into 2 parts: the pelvic urethra and the urethra passing through the penis. The diameter of the pelvic urethra is much wider than that of the penile urethra, which makes it easy for uroliths to enter, but they get stuck in the narrow part. In dogs, this is also facilitated by the presence of penile bone, which greatly reduces the diameter of the urethra.

Symptoms of obstruction start acutely - the animal constantly assumes a posture for urination, pushes, but urine does not come out or comes out in drops. Very often these drops have an admixture of blood. Quite quickly the animal's condition worsens, and in a relatively short period of time (about a day) renal failure may develop.

Such an animal should be urgently hospitalized and urine outflow should be restored. For this purpose, a urethral catheter is inserted. But, unfortunately, it often happens that due to the dense accumulation of stones, it becomes impossible to install the catheter (because it simply does not pass into the bladder) - in this case, the only way to solve the problem is surgical intervention.

The essence of surgical intervention is to dissect the urethra in the area above the obstruction, remove the uroliths and suture the urethra (urethrotomy) or form a new urethral exit mouth on the skin - urethrostomy. Urethrostomy is performed when there is a small amount of uroliths in the urethra, the urethra is intact and the risk of recurrent obstruction is very low. The disadvantage of this operation is that a scar is formed at the site of the incision and suture, which further reduces the lumen of the urethra. Urethrostomy allows the creation of a permanent urinary outlet in a wider part of the urethra where obstruction is less likely.

There are many options for performing a urethrostomy, depending on the species of animal and the localization of the obstruction:

• Prescrotal (dogs only);
• scrotal (dogs only) is the best option;
• perineal (male cats, male cats) - best for cats;
• Prelonatal (male dogs, female dogs, female dogs, male cats, female cats) - "universal" but potentially carries the highest number of complications compared to previous methods.

Urethrostomy does not affect your pet's urinary control in any way, that is: after the surgery, your pet will still be able to control its own urination (cats go to the litter box, dogs tolerate to go for a walk).