Urinary blockages are a serious concern for cats and have the potential to be life-threatening. If the routine solutions have proven to be ineffective then your vet may recommend surgical correction. In today's post, our Boulder and Westminster vets talk about perineal urethrostomy (PU) surgery in cats and what will happen during your cat's surgery and recovery.

What Is Perineal Urethrostomy (PU) Surgery in Cats?

A perineal urethrostomy (PU) is a surgical procedure that reconstructs the urethra, the tube that your cat uses to urinate. The goal is to create a larger opening for your cat to urinate through. PU surgery is usually considered after it has been determined that urinary obstructions cannot be corrected by catheterization or if the cat has had multiple obstructions.

Urinary blockages can very quickly become life-threatening for your cat. While this surgery is used to greatly decrease the likelihood of repeat blockages it will not guarantee that obstructions will not reoccur. The care taken after surgery will help to ensure that the procedure was a success and lower the risk of future blockages.

While possible in both, it is much more likely for a male cat to experience urinary blockages than female cats due to the female urethra being much shorter and wider than the male urethra. As the male urethra extends the length of the penis it becomes more narrow increasing the likelihood of an obstruction occurring.

When might cat PU surgery be needed?

Perineal urethrostomy surgery is most commonly recommended in the following situations.

  • A urethral obstruction within the penis that cannot be removed. The most common treatment for urethral obstructions is through the use of a urinary catheter. Your vet would pass this catheter through the external opening of the urethra forcing any stones or mucus within the urethra into the bladder, at which point they can be managed using medication or surgery. If this method is unable to clear the blockage then perineal urethrostomy surgery may be required in order to allow the cat to urinate.
  • Recurrent urethral obstructions. It is possible for obstructions to be common and recurring in some male cats. Although it is possible to continually remove the blockages in these cats, they may also benefit from perineal urethrostomy surgery to try to avoid or lower the risk of future obstructions.

Are urethral obstructions an emergency?

Yes, urethral obstructions in cats are considered a medical emergency because they can quickly lead to life-threatening complications, such as kidney failure and rupture of the bladder. Immediate veterinary intervention is necessary to relieve the obstruction and prevent further damage to the cat's health. 

What should I expect during my cat's PU surgery? 

The main issue addressed during PU surgery is the narrow urethra in the distal penis, so the surgery's goal will be to widen the urethra. Your veterinarian will finish the job by incising the penis and suturing it open to create a stoma (an opening) and drainage board. The drainage board will shrink and your cat's fur will grow back in the weeks following surgery, giving your cat the appearance of a female cat rather than a male. You may be concerned about the cost of PU Surgery for urinary obstructions in cats if you are planning to schedule an appointment for your feline friend. The final cost will be determined by your cat and its condition.

What should I expect during my cat's recovery from PU surgery? 

Because cats are notorious for attempting to clean and lick their wounds as well as the chance that they may attempt to scratch or bite at the area it is recommended that your cat wear an Elizabethan collar for the duration of the recovery process.

Your veterinarian will also recommend that you keep your cat in a room where they can relax and not climb or jump onto furniture. Your cat should also be kept separate from other pets to limit interactions and playtime that could cause further injury.

What is the long-term prognosis for cats after PU surgery?

If your cat's PU surgery was successful and the recovery period was uneventful, there should be no further concerns. It is possible for a cat to develop another obstruction after undergoing PU surgery, but this is highly unlikely.

Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.

Your cat's inability to urinate should never be ignored. Contact our Boulder and Westminster vets immediately if you notice your cat straining to urinate or if they haven't urinated in quite some time. Time could be of the essence.