Prepubic urethrostomy: A long-term study in 16 cats

Objective-To investigate the indications for and long-term outcome of prepu bic urethrostomy (PPU) in the cat. Study Design-Retrospective survey. Animals-Sixteen cats that had undergone PPU. Methods-Data were recovered from the medical records of the cats. Follow-up information was obtained from the owners and referring veterinarians. Results-Indications for PPU were: failed perineal urethrostomy for the mana gement of idiopathic lower urinary tract disease (ILUTD) (8 cats) or urethr al trauma (1 cat); unresolved pelvic urethral obstruction after recurrent I LUTD (5 cats); and stenosis of the pelvic urethra as a result of trauma (2 cats). A patent urethral stoma was created in all cases. Signs of lower uri nary tract disease were present in 8 cats postoperatively. With appropriate dietary management, these signs resolved in 2 cats and improved in another 4 cats. Eleven cats experienced postoperative complications that consisted of peristomal skin irritation or necrosis (7 cats) and urinary incontinenc e (6 cats). Complications developed in the immediate postoperative period i n 6 cars, and resolved in 2 of these. Six cats developed late complications , at 6 to 84 months postoperatively. Six cars were euthanatized between 1 a nd 26 months' postoperatively. The mean survival time in these cats was 13 months. Reasons for euthanasia included urinary incontinence (3 cats), skin necrosis (2 cats), and unresolvable ILUTD (1 cat). Conclusions-PPU is a salvage procedure that is successful in relieving the signs of urinary tract obstruction and preventing further obstruction. Howe ver, potential complications should limit its use to cases in which standar d techniques for perineal urethrostomy cannot be performed. Clinical Relevance-PPU is a comparatively simple procedure that should be c onsidered as a salvage technique for obstructive disease of the pelvic uret hra. (C) Copyright 2001 by The American College of Veterinary Surgeons.