Complications of Urethrostomies

Perineal Urethrostomy: The feline perineal urethrostomy (PU) procedure has been performed with few alterations since the original description by Wilson in 1971. A minor modification of the technique was proposed by Agrodnia and others, in which two continuous suture patterns were applied using absorbable suture material (polydioxanone). This modification allows for decreased operative time, minimizes the volume of suture material in the wound and obviates the need for suture removal, which can often require sedation. No strictures or dehiscences were noted in the 18 cases that were reported, and overall complication rate was similar to previous reports. Despite the widespread success of PU in accomplishing patent urinary diversion in cats, a number of complications have been reported, including stricture of the urethrostomy, subcutaneous urine leakage in the perineal region, hemorrhage, urinary tract infection and incontinence. Although some of these complications can be managed conservatively, many require surgical revision to restore urinary function. Thus, almost since the inception of the PU procedure, there has been a need for revision methods.