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SURGERY
How to Perform a
Feline Perineal
Urethrostomy
A step-by-step surgical guide, tips to optimize results,
and revision techniques, just in case.
By Christopher Adin, DVM, DACVS
Perineal urethrostomy is a surgical method for allevi-
ating urethral obstruction in cats with complicated or
recurrent obstructive feline lower urinary tract disease.
While long-term quality of life after perineal urethros-
tomy in cats with obstructive feline lower urinary tract
disease is good (as assessed by owners) and the re-
currence rate is low, there are several potential intra-
operative and postoperative complications. The good
news is that with proper technique and equipment,
these can be avoided.
Traditional technique for perineal urethrostomy
Step 2. After draping, place and secure a uri-
nary catheter. I prefer to use a 5-Fr red rubber
catheter, securing it with either a finger trap
suture or by clamping the catheter in the pe-
nis using Allis tissue forceps. The latter technique al-
lows you to manipulate the penis and provide tension
during dissection. It is helpful to use a sterile marker to
plan the incision location, tracing a fusiform-shaped
incision that includes the penis and scrotum, but ter-
minates at least 1 cm ventral to the anus (Figure 1).
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Step 1. Position the cat in perineal position,
with padding under the cranial thighs to pre-
vent neurovascular injury during restraint.
Aseptically prepare the perineal area, which
usually requires removing the urinary catheter if one
was placed before surgery. Step 3. After making an incision with a scalpel
blade, incise the subcutaneous tissue until
the penis is isolated (Figure 2). Begin dissec-
tion around the penis on the lateral side, pull-
ing the penis to the opposite side to create tension
on the site of dissection and to improve exposure in
that region. I prefer to use tenotomy scissors to per-
form this dissection because the delicate, blunt tips
are well-suited for this area.
Figure 1 (Figures courtesy of Dr. Christopher Adin) Figure 2
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Issue 02 | APRIL 2017 | 8
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