What is Perineal Urethrostomy (PU) surgery?
A perineal urethrostomy (PU) is a surgical reconstruction of the urethra. The purpose is to create a larger opening through which your cat can urinate. Typically, PU surgery is considered once your vet has determined your cat's urinary obstruction either cannot be corrected by catheterization or if the cat has been experiencing repeated obstructions.
Urinary blockages can quickly become life-threatening for your cat. Although this surgery is used to decrease the likelihood of repeat blockages in your cat's urethra, it will not guarantee that obstructions will not reoccur. Post-surgical care is essential to ensure that the procedure turns out a success and lowers the risk of future blockages.
Male cats are at much higher risk of experiencing urinary blockages than female cats due to the female urethra being much shorter and wider than the male urethra. Due to the male urethra extending the length of the penis, it becomes more narrow, increasing the likelihood of an obstruction occurring.
What Is The Goal Of PU Surgery?
The main concern that is addressed during PU surgery is the narrow urethra in the distal penis, so the goal of the surgery will be to widen the urethra. Your vet will complete this by incising the penis and suturing it open to create a stoma (an opening) and drainage board. Over the weeks following surgery, the drainage board will shrink and your cat's fur will grow back and leave your cat with more of an appearance of a female cat rather than a male.
When Is PU Surgery Recommended?
Perineal urethrostomy surgery is most commonly recommended for cats 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 this point, they can be managed using medication or surgery. If this method is unable to clear the blockage, perineal urethrostomy surgery may be required to allow the cat to urinate.
- Recurrent urethral obstructions. Obstructions can become common and reoccur in 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.
Recovery After PU Surgery
Cats are notorious for attempting to clean and lick their wounds. With this habit, they may attempt to scratch or bite at their privates after surgery. Your veterinarian will likely recommend your cat wear an Elizabethan collar for the duration of the recovery process to help them heal.
It’s also a good idea to keep your cat in an area where they can relax in your home and will not be able to climb or jump onto furniture. Your cat should also be isolated from other pets to limit interactions and possible playtime, which could further injure your cat.
What to Expect Once Your Cat Has Had PU Surgery
If your cat has undergone PU surgery that was successful and the recovery process happened without complications then there should be no further concerns. It’s rare for cats to experience another obstruction after having PU surgery.
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.