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SURGERY
Article reprinted with the permission of DMV360, March 2014, DMV360 is a copyrighted publication of Advanstar. Communications inc. All rights reserved.
How to Perform a Scrotal Urethrostomy
And Stop the Stone Cycle
By Don R. Waldron, DVM, DACVS
VETERINARY MEDICINE
Male dogs suffering from recurrent urethral blockage due
to urinary calculi may benefit from this procedure that
permanently diverts urine flow.
Scrotal urethrostomy is a permanent urinary diversion procedure performed in dogs that have chronic
or recurrent urethral blockage due to urinary calculi.
Urethral calculi in male dogs may cause partial or total
urethral obstruction by lodging in the urethra, usually
at the base of the os penis. Less common indications
for urethrostomy include urethral stricture from previous calculus injury or surgery, penile or preputial neoplasia, or severe trauma that necessitates penile and
preputial amputation.
Scrotal urethrostomy requires scrotal ablation and
neutering of intact male dogs. Complications of urethrostomy in dogs include haemorrhage from the
urethra during the immediate postoperative period
and an increased risk of urinary tract infection long
term. Stricture of the surgical site is uncommon because of the width of the urethra at this level. Haemorrhage and stricture are both minimized by accurate
apposition of the urethral mucosa to the skin.
Preoperative assessment and
preparation
while the patient is anaesthetised but before starting the urethrostomy procedure. If
cystic calculi are present, perform a cystotomy before starting the urethrostomy procedure to remove all bladder calculi. If possible, place an indwelling urethral catheter,
which is to be maintained during the urethrostomy. Perform the urethrostomy
before the bladder and abdominal walls
are closed to allow for normograde and retrograde urethral
catheter passage and lavage to ensure urethral patency.
How to perform a scrotal urethrostomy:
A step-by-step guide
NOTE: The dog's head is to the left.
Step 1:
In intact dogs, make an elliptical skin incision near the base
of the scrotum, preserving about 1 cm of scrotal skin on
Before the surgery, perform appropriate blood work
to ensure the patient’s stability, giving special attention to renal and electrolyte values. Perform abdominal and perineal radiography or ultrasonography to
assess the entire urinary tract for calculi. After anaesthesia is induced, position the dog in dorsal recumbency and prepare the caudal abdomen, including
the prepuce and scrotum, for surgery by clipping and
performing appropriate aseptic preparation.
If the patient is urethrally obstructed, calculi can be
flushed back into the urinary bladder via retropulsion involving careful catheterization and fluid lavage
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