Urethrostomy

A surgical procedure for creating a permanent opening in the urethra of dogs

Overview

A canine scrotal urethrostomy procedure in progress.

A urethrostomy is a surgical procedure performed to create a permanent opening in the urethra to allow urine to bypass an obstruction or to address other medical conditions affecting the lower urinary tract. This procedure is commonly performed in canine patients, particularly male dogs, due to their anatomical predisposition to urethral obstructions.

Indications

Urethrostomy is indicated in cases where there is a recurrent or persistent obstruction of the urethra that cannot be managed by less invasive means. Common causes of urethral obstruction in dogs include:

• Urolithiasis (urinary stones)
• Urethral stricture
• Neoplasia (tumors)
• Severe trauma to the urethra

Types of Urethrostomy

There are several types of urethrostomy procedures, each named according to the location of the new urethral opening:

• Scrotal urethrostomy: The most common type performed in male dogs, where the opening is created in the scrotal area. This location is preferred due to the wider diameter of the urethra in this region, which reduces the risk of postoperative complications.
• Perineal urethrostomy: Typically performed in cats, but can be used in dogs when scrotal urethrostomy is not feasible.
• Prepubic urethrostomy: Used as a last resort when other types are not possible, involving the creation of an opening in the abdominal wall.

Procedure

The procedure involves the following steps:

1. Anesthesia: The dog is placed under general anesthesia to ensure it is pain-free and immobile during the surgery. 2. Incision: An incision is made in the selected area (e.g., scrotal region for scrotal urethrostomy). 3. Urethral Dissection: The urethra is carefully dissected and mobilized to create a new opening. 4. Stoma Creation: The urethra is sutured to the skin to form a stoma, which will serve as the new exit point for urine. 5. Closure: The surrounding tissues are closed, and the area is cleaned and bandaged.

Postoperative Care

Postoperative care is crucial for the success of the surgery. It includes:

• Monitoring for signs of infection or complications
• Ensuring the stoma remains patent and free of debris
• Administering prescribed medications, such as antibiotics and pain relief
• Restricting activity to allow for proper healing

Complications

Potential complications of urethrostomy include:

• Infection
• Stenosis (narrowing) of the stoma
• Bleeding
• Urinary incontinence

Prognosis

The prognosis for dogs undergoing urethrostomy is generally good, provided that the underlying cause of the obstruction is addressed and proper postoperative care is given. Most dogs can return to a normal quality of life following recovery.

Related pages

• Urolithiasis
• Urethral stricture
• Veterinary surgery