Comparison of surgical indications and short- and long-term complications in 56 cats undergoing perineal, transpelvic or prepubic urethrostomy.

Abstract

OBJECTIVES: The aim of this study was to compare indications, complications and mortality rates for perineal urethrostomy (PU), transpelvic urethrostomy (TPU) and prepubic urethrostomy (PPU). METHODS: A retrospective review of, and follow-up owner questionnaire for, cats undergoing urethrostomy between 2008 and 2018, at a single referral hospital, were performed. RESULTS: Fifty-six cats underwent urethrostomy (PU, n&#x2009;=&#x2009;37; TPU, n&#x2009;=&#x2009;8; PPU, n&#x2009;=&#x2009;11). The presenting problem was significantly associated with urethrostomy technique (<0.001). For PU cats, feline idiopathic cystitis (FIC; n&#x2009;=&#x2009;21 [56.7%]) was the most common problem, whereas for PPU cats, trauma (n&#x2009;=&#x2009;9 [81.8%]) was most common (<0.001). Urethrostomy technique was associated with imaging diagnosis (<0.001) of the urethral lesion. Most PU cats had no diagnostic imaging lesion (n&#x2009;=&#x2009;15 [40.5%]) or obstructive calculi or clots (n&#x2009;=&#x2009;10 [27.0%]), and all PPU cats had urethral rupture. Ten (90.9%) PPU cats had a pelvic lesion, while 21 (56.7%) PU cats had a penile lesion. TPU cats had a range of presenting problems and imaging diagnoses. Short- and long-term complications were reported in 33/55 (60.0%) and 11/30 (36.7%) cats, respectively. The number of cats with long-term complications was greater among PPU cats (&#x2009;=&#x2009;0.02). Short-term dermatitis (&#x2009;=&#x2009;0.019) and long-term incontinence (&#x2009;=&#x2009;0.01) were associated with PPU. Short-term mortality was 5.6% and long-term mortality was 13.3%; both were independent of urethrostomy technique. Quality of life post-urethrostomy, across all techniques, was graded as good by 93% of owners. CONCLUSIONS AND RELEVANCE: In this study, PU was the most common feline urethrostomy technique indicated for FIC. Short-term urethrostomy complications are common, irrespective of urethrostomy technique. Long-term complications are less frequent but more common with PPU.