Chapter 14: Table of Contents
Urethrostomy procedures consist of creating a permanent communication between the urethra and the skin without affecting urinary continence. Urethrostomy is typically performed in patients with recurrent urethral obstruction in order to increase the diameter of the urethral opening to allow the excretion of calculi during urination. Other indications include an obstruction that cannot be relieved or severe trauma to the distal urethra. Scrotal urethrostomy is most commonly performed although perineal and prescrotal urethrostomy are sometimes necessary. Scrotal urethrostomy is preferred over other locations in dogs for the following reasons:
- The scrotal urethra has the widest diameter, which decreases the risk of postoperative stricture and facilitates postoperative excretion of recurrent calculi.
- The scrotal urethra is located in a superficial location, which facilitates apposition of the urethral mucosa and skin for urethrostomy.
- At this level, the urethra is surrounded by less cavernous tissue than at other levels decreasing intra and postoperative hemorrhage.
- The scrotal location results in less urine scald and peri-urethrostomy skin irritation than other urethrostomy sites.
Scrotal urethrostomy is not a consideration for breeding animals or when the owners object to castration; prescrotal urethrostomy should be considered in those patients but the increased risk of stricture and other complications should be considered.