Study sheds light on feline perineal urethrostomy
New research published in the Journal of Small Animal Practice (JSAP) suggests that it might be possible to predict the likelihood of re-obstruction following feline perineal urethrostomy.
Perineal urethrostomy is a procedure used to relieve urethral obstruction in male cats, in which medical management has failed. It involves creating a permanent new stoma in the pelvic urethra, situated close to the obstruction.
In the study, 24 male cats with lower urinary tract infections underwent the procedure. The urethral orifice cross-section was estimated by the largest urinary catheter that could be easily inserted through the stoma at three-time points: preoperatively, intra-operatively and 12 days postoperatively.
Cases of obstruction recurrence and structure were documented within the six months follow up period.
Corresponding author Uri Segal said: “The intraoperative stoma ranged from 1 to 10 (median 10) Fr and the 12-day postoperative stoma ranged from 4 to 10 (median 8) Fr. There was significant reduction of stoma size 12 days postoperatively, compared to the measurements taken intraoperatively. Postsurgical stricture formation and re-obstruction was documented in five of 24 (21%) of cats.
“Obstruction recurrence is probable if the intra-operative stoma size is 8 Fr or less. Furthermore, if the stoma size is 6 Fr or less, re-obstruction is almost certain (all of these cases in the study were re-obstructions). Conversely, an intra-operative stoma of more than 8Fr had a low risk of recurrence."
JSAP editor Nicola Di Girolamo concluded: “These findings may function as a guiding rule for surgeons performing perineal urethrostomy, by providing an intraoperative measure of how likely re-obstruction and stricture formation is to occur.
"It should be remembered, however, that the functional urethral stoma cross-section may vary during the urination cycle and the measurements in this study are likely to only represent a fraction of the functional urethral cross-section size.”