Perineal Urethrostomy in Cats

Male cats can be prone to a very painful and potentially life-threatening condition where their urethra (the tube that runs outwards from the bladder) gets blocked by uroliths (bladder stones that form in the bladder), resulting in an inability to pass urine. The male cat might be seen crying as it tries to pass urine and quickly becomes very distressed. If left untreated it can result in damage to the kidneys, cause the bladder to rupture and ultimately death. Usually, we can treat this condition by passing a urinary catheter and flushing the small stones back into the bladder. Special diet food can change the pH of the urine and encourage the stones to dissolve. Unfortunately for some cats it becomes a recurring problem that is both distressing for the cat and potentially very expensive for the owner.

The reason we rarely see this problem in female cats is that the urethra is the same diameter all the way along, from where it starts in the bladder to where it exits, so if a stone is small enough to get into the female urethra, generally it can be passed out. In male cats the urethra gets very narrow right as it exits the body through the male genitalia.

In rare cases where a male cat repeatedly gets blocked, a surgical procedure can be performed to create an opening (stoma) just before the point at which the urethra gets narrowed. For the male cat this means a fairly drastic procedure to remove the last section of urethra i.e. the cat's penis. For those of you that are still reading at this point, this is the operation I had to perform this month on a cat whose owners had feared they would have to have him euthanised due to recurring blockages and distress. It is very tricky and delicate surgery and generally we only perform it when all other treatment options fail but, if successful, it means it is very unlikely that the cat will ever suffer a blockage again. Fortunately, my patient has done very well and the owners report not only an excellent stream of urine but a look of relief on his face that suggests he is quite reconciled with the outcome!