Perineal urethrostomy in the cat: when it is indicated
Which of these situations is an appropriate indication for perineal urethrostomy?
chevron_right Show answer and explanation
A. Repeated urethral obstructions despite good medical and environmental management, or a stone or stricture in the penile urethra that cannot be resolved otherwise
Correct. Surgery widens the urethral outlet by removing the penile segment, the narrowest part. It is a solution for distal obstruction, not for the underlying bladder disease.
B. First episode of urethral obstruction by a plug, to prevent recurrence
Many cats do not block again with good medical management. Surgery has complications and is not recommended after a first episode.
C. Recurrent non-obstructive idiopathic cystitis, to reduce flare-ups
Urethrostomy does not act on the bladder or on stress. Cystitis flare-ups will continue, and it also increases the risk of urinary infection.
D. Obstruction by a urolith lodged in the proximal or pelvic urethra
Perineal urethrostomy does not reach the pelvic urethra. These stones are flushed back into the bladder by retrohydropulsion and removed afterwards.
lightbulb Key takeaway
Perineal urethrostomy prevents distal obstruction but does not cure idiopathic cystitis. Before operating, check that medical management has been done properly and explain that the cat may still have flare-ups and more urinary infections.
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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.