Complications of perineal urethrostomy in the cat
6-year-old neutered male cat that underwent perineal urethrostomy four weeks ago. He went home without an Elizabethan collar and licked the wound. He now strains to urinate and the stoma looks small and fibrotic.
What is the most likely cause and how is it prevented?
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A. Recurrence of idiopathic cystitis; prevented with antibiotics after surgery
Cystitis can recur, but a small, fibrotic stoma indicates stricture. Antibiotics prevent neither idiopathic cystitis nor stricture.
B. Incontinence due to sphincter injury; prevented by avoiding urethral dissection
The cat is not incontinent but has difficulty urinating. Moreover, insufficient dissection is precisely a cause of stricture.
C. Stoma stricture; prevented by dissecting the urethra to the bulbourethral glands, suturing mucosa to skin without tension and preventing licking
Correct. Stricture is the most common serious complication. It is associated with insufficient dissection (stoma in narrow urethra), tension, urine leakage into the subcutis and licking trauma.
D. Obstruction by a new urethral plug; prevented with a struvite dissolution diet
After a well-performed urethrostomy the urethra is wide and plugs rarely obstruct. The appearance of the stoma points to stricture.
lightbulb Key takeaway
After urethrostomy: Elizabethan collar until suture removal, avoid an indwelling catheter if possible and check the stoma. Long term, these cats have more urinary infections: culture the urine if signs return.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.