Perineal Urethrostomy (PU) surgery is a surgical procedure that reconstructs a cat’s urethra to create a larger opening for urination. It’s most often performed on male cats with urinary obstructions, which are more common in males due to differences in urinary tract anatomy. PU surgery is typically considered when catheterization can’t clear the obstruction or if the cat has had repeated obstructions. Less commonly, this surgery may also be performed in cats with severe urethral trauma.

To fully understand the complexities of the PU surgery, it is important to first understand the urinary blockage. A urinary blockage is one of the major emergencies affecting cats and can quickly become life-threatening. Male cats can easily develop obstruction of the urethra which is the tube draining urine from the bladder out of the penis.  Obstructions are often the result of plugs of inflammatory material, such as mucus, crystals, small stones (called calculi) that have formed in the kidneys and then passed down into the bladder.

Once a cat becomes completely obstructed or blocked, they may attempt to urinate frequently in the litterbox, but will produce no urine. Typically, cats cry/yowl, move restlessly, or hide because of discomfort. Eventually, cats will lose their appetite and become lethargic.

Treating a blocked cat involves emptying the bladder, relieving the urethral blockage, and dealing with the developed biochemical abnormalities. This is typically done by placing a catheter through the urethra and leaving it in place until the bladder has had a chance to remain empty and recover. Blocked cats may stay hospitalized at our clinic for 4-7 days. If the cat re-blocks, then the PU surgery could be the next step.

During the PU procedure, the surgeon makes a new opening in the urethra allowing easier urination with a lower risk of a reoccurring obstruction. The word perineal refers to the location of the new hole between the penis and the anus; the term urethrostomy is the process of surgically making the new hole.

While PU can reduce the chance of another urinary blockage, it’s not a perfect solution.  Cats that have had the surgery are more prone to urinary tract infections and can in rare cases still become obstructed again. Post-operative preventative care is very important to the success of this surgery. Cats who have had urinary blockages and/or the PU surgery, will have to be on a urinary prescription diet for the rest of their lives.

If you are unsure your male cat is producing urine, have him evaluated by a veterinarian immediately. Life-threatening consequences can occur in as little as 12-24 hours of being unable to urinate. Death from untreated obstructions may occur in as little as 36-48 hours.

If your cat has been diagnosed with a urinary blockage, call us today at 970-694-2625!

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