Perineal Urethrostomy (PU) in Cats

Overview of the Perineal Urethrostomy (PU) Surgery in Cats

Perineal urethrostomy, commonly referred to as a “PU”, is the procedure that is done to make a new opening in the urethra in the perineal area (the area between the scrotum and the anus). The procedure is most commonly done in male cats that suffer from Feline Lower Urinary Tract Disease (FLUTD) and to bypass an obstruction of the urethra in the penis. It is also indicated if there is trauma to the penis or lower urethra.

Most FLUTD cats are 2-6 years old neutered males, sedentary and overweight. The cause of FLUTD is unknown, but FLUTD cats are predisposed to urethral obstruction. And an animal that has suffered trauma to the urethra, either from a laceration caused by a broken pelvic bone, direct injury to the penis, or from traumatic catheterization of the urethra, may require a perineal urethrostomy.

Questions Your Vet May Ask About Your Cat

Your veterinarian will ask you many questions to develop a complete history of the progression of the problem in the cat. These questions will include:

Your veterinarian will also examine your cat completely, including checking for a fever and listening to his heart and lungs. He/she will palpate (feel) you pet’s abdomen to check for an enlarged bladder, fluid in the abdomen or pain in the abdomen. Animals that cannot urinate due to an obstructed urethra can become very ill and may require emergency treatment.

Diagnostic Tests Before Perineal Urethrostomy (PU) in Cats

Treatment of Cats with a Perineal Urethrostomy Surgery

Home Care

Information In-depth on Perineal Urethrostomy (PU) in Cats

Perineal Urethrostomy (PU) is the medical term for the creation of a new opening in the urethra (the tube which carries urine from the bladder to the outside). This is done in the perineum, which is the area between the scrotum and anus. A PU is done to bypass the smaller diameter urethra in the penis and open the larger diameter urethra in the pelvic area.

Indications for a PU include:

The cause for FLUTD is unknown. Most cats with FLUTD are young adult neutered males, 2-6 years old. They are often sedentary and overweight. They develop grit and plugs of debris in their urine which can obstruct the flow of urine out the urethra.

If the animal has suffered trauma to the pelvis, especially if there are fractured pelvic bones, the urethra can become damaged as well. These cats may also require urethrostomies.

Cats that are obstructed due to FLUTD need to be unobstructed by means of a urinary catheter. This can be difficult and can result in damage to the urethra. If the urethra is damaged, or if a catheter is unable to be passed, a PU may be necessary.

Diagnosis In-depth Prior to Perineal Urethrostomy (PU) in Cats

Therapy In-depth with Perineal Urethrostomy (PU) in Cats

The surgery involves removing the penis and scrotum (and testicles if the cat has not already been castrated) and making a new opening in the wider area of the pelvic urethra. The urethral lining (mucosa) is sutured to the skin of the perineum. The skin will heal to the mucosa, creating a new permanent urethral opening.

Follow-up Care for Cats After Perineal Urethrostomy

Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your pet does not rapidly improve.