Prepucial urethrostomy performed using the coating technique
Penile urethral obstruction in cats is a commonly seen clinical case in veterinary medicine practice. In cases where there is no response to catheterisation or medical intervention, surgery is needed to enable urination and correct uraemia and hyperkalaemia. Several surgical techniques of urethrostomy have been described for this aim. In performing standard prepucial urethrostomy great care must be taken to minimise leakage in the anastomosis site and promote healing when performing the pelvic urethra and prepucial mucosa anastomosis. To achieve this, the line of anastomosis has been reinforced by covering the anastomosis with the bilateral bulbourethral tissue, m. ischiourethralis and m. ischiocavernosus using simple mattress sutures. This modification, which varies from the technique performed by Yeh and Şaroğlu, has been termed the coating technique. Advantages of this new technique over standard perineal urethrostomy are discussed. This technique was used in the treatment of 55 cats with penile urethra obstruction presented to our clinic. Among them 52 cats showed uncomplicated recovery. Following anastomosis, a male dog urethral catheter with an outer diameter of 2.6 mm was placed in each patient. In order to avoid infection, the catheter was removed after 2 days. Stenosis developed after 1 month in 3 cases in which normal urination was resumed by performing the standard perineal urethrostomy. All cats returned to good health.
Prepucial urethrostomy performed using the coating technique
Penile urethral obstruction in cats is a commonly seen clinical case in veterinary medicine practice. In cases where there is no response to catheterisation or medical intervention, surgery is needed to enable urination and correct uraemia and hyperkalaemia. Several surgical techniques of urethrostomy have been described for this aim. In performing standard prepucial urethrostomy great care must be taken to minimise leakage in the anastomosis site and promote healing when performing the pelvic urethra and prepucial mucosa anastomosis. To achieve this, the line of anastomosis has been reinforced by covering the anastomosis with the bilateral bulbourethral tissue, m. ischiourethralis and m. ischiocavernosus using simple mattress sutures. This modification, which varies from the technique performed by Yeh and Şaroğlu, has been termed the coating technique. Advantages of this new technique over standard perineal urethrostomy are discussed. This technique was used in the treatment of 55 cats with penile urethra obstruction presented to our clinic. Among them 52 cats showed uncomplicated recovery. Following anastomosis, a male dog urethral catheter with an outer diameter of 2.6 mm was placed in each patient. In order to avoid infection, the catheter was removed after 2 days. Stenosis developed after 1 month in 3 cases in which normal urination was resumed by performing the standard perineal urethrostomy. All cats returned to good health.
___
- Folger, W.R.: Calcium oxalate urolithiasis in a cat. Feline Pract., 1999; 27: 17-20. 8.
- Gregory, C.R., Vasseur, P.B.: Long-term examination of cats with
- perineal urethrostomy. Vet. Surg. 1983; 12: 210-212. 9.
- Gregory, C.R., Vasseur, P.B.: Electromyographic and urethral
- pressure profilometry: long-term assessment of urethral
- function after perineal urethrostomy in cats. Am. J. Vet. Res., 1984; 45: 1318-1321.
- Gregory, C.R., Holliday, T.A., Vasseur, P.B., Bruhl-Day, R.A.G.A., Parker, H.R., McNeal, D.: Electromyographic and urethral pressure profilometry: assessment of urethral function before and after perineal urethrostomy in cats. Am. J. Vet. Res., 1984; 45: 2062- 2065.
- Griffin, D.W., Gregory, C.R.: Prevalence of bacterial urinary tract infection after perineal urethrostomy in cats. J. Am. Vet. Med. Assoc., 1992; 200: 681-684.
- Johnston, D.E.: Feline urethrostomy - a critique and new method. J. Small Anim. Pract., 1974; 15: 421-435.
- Kyles A.E., Stone E.A.: Urethra. In: Current Techniques in Small Animal Surgery. Ed. Bojrap M. J. Ed., Williams & Wilkins. Baltimore 4thEdn. 1998; 461- 477.
- Long, R.D.: A technique for perineal urethrostomy in the cat. J. Small Animal Pract., 1977; 18: 407-413.
- McLoughlin, M.A.: Surgical emergencies of the urinary tract. Vet. Clin. North Am. Small Anim. Pract., 2000; 30: 581-601.
- Mendham, J.H.: A description and evaluation of antepubic urethrostomy in the male cat. J. Small Anim. Pract., 1970; 11: 709-721.
- Osborne, C.A., Caywood, D.D., Johnston, G.R., Polzin, D.J., Lulich, J.P., Kruger, J.M.: Perineal urethrostomy versus dietary management in prevention of recurrent lower urinary tract disease. J. Small Anim. Pract., 1991; 32: 296-305.
- Osborne, C.A., Kruger, J.M., Lulich, J.P., Bartges, J.W., Polzin, D.J.: Medical management of feline urethral obstruction. Vet. Clin. North Am. Small Anim. Pract., 1996; 26: 483-498.
- Osborne, C.A., Caywood, D.D., Johnston, G.R., Polzin, D.J., Lulich, J.P., Kruger, J.M., Ulrich, L.K.: Feline perineal urethrostomy: a potential cause of feline lower urinary tract disease. Vet. Clin. North Am. Small Anim. Pract., 1996; 26: 535- 549.
- Wilson, G.P., Harrison, J.W.: Perineal urethrostomy in cats. J. Am. Vet. Med. Assoc., 1971; 159: 1789-1793.
- Sevestre J.: Elements de Chirurjie Animale. Chirurgie Abdominale. Tome. 2. Les editions du point veterinaire. Paris. P. 1979 ; 149-157.
- Slatter, D.: Textbook of Small Animal Surgery. 2ndedn., 1983; 1465-1468.
- Smith, C.W.: Effects of indwelling catheters in male cats. J. Am. Anim. Hosp. Assoc., 1981; 17: 427.
- White, R.N., Tick, N.T., White, H.L.: Naturally occurring xanthine urolithiasis in a domestic shorthair cat. J. Small Anim. Pract., 1997; 38: 299-301.
- Yeh, L.S., Chin, S.C.: Modified perineal urethrostomy using preputial mucosa in cats. J. Am. Vet. Med. Assoc., 2000; 216: 1092-1095.
- Saroglu, M., Acar, S.E., Duzgun, O.: Urethrostomy done using the anastomosis technique of the prepuce mucosa to the pelvic urethra in cats with penile urethral obstruction. Vet. Med.- Czech., 2003; 48: 229-234.