Urethra - Urethrostomy

Question 1

What is a urethroStomy

Answer 1

This procedure is commonly known as ‘a sex change operation’.

Question 2

When is this procedure recommended?

Answer 2

when the cause of the urethral obstruction cannot be treated or if the patient has reoccurring obstructions with unsuccessful medical dissolution.

Question 3

When is a UrethroStomy performed in cats

Answer 3

In felines a perineal urethrostomy is performed, where the penis is amputated and a permanent new opening is made into a wider part of the urethra to allow urinary stones to pass out without obstructing.

Question 4

When is a UrethroStomy performed in dogs?

Answer 4

In canines a scrotal urethrostomy, castration, and scrotal ablation is performed. This involves making an incision at the prescrotal penis. The urethra is then sutured to the skin edges. A urinary catheter is not normally placed in patients following an urethrostomy.

Question 5

Patient Prep

Answer 5

For a perineal urethrostomy, the entire perineal area should be clipped as per the image below, and a purse string suture placed into the anus. The site can then be prepared aseptically. For a scrotal urethrostomy in dogs, the clip is much the same as that of canine castration.

Question 6

Patient Positioning

Answer 6

For a perineal urethrostomy, the cat is placed in sternal recumbency with the hind limbs hanging over the end of the table. A support bag or rolled up towel is placed under the pubic area and the tail is bandaged and elevated away from the surgical site. For a scrotal urethrostomy the dog is placed in dorsal recumbency with the limbs secured out of the way.

Question 7

Instruments / Materials

Answer 7

A general surgical kit, a urinary catheter, and suture material are required. Either a fenestrated drape appropriate to the patient’s size or four quarter drapes can be used.

Question 8

Post op

Answer 8

It is common to observe considerable bleeding with urination, and patient should be hospitalised until this reduces. The surgical site must be kept clean and free of urine and blood to prevent urine scalding. Barrier cream can also be applied to prevent this, until the animal learns how to reposition for urination