Urethrotomy and urethrostomy in the dog.

An incision, or urethrotomy, is made into the urethral lumen to remove or relieve an obstruction temporarily. When permanent diversion of urine flow proximal to an obstructed, severely damaged, or diseased urethra is required, a urethrostomy is performed. Urethrostomy is also performed to diminish the risk of urethral obstruction due to recurrent urinary calculi that are not likely to be resolved with medical therapy. Whenever possible, to reduce the risk of urethral stricture or recurrent urinary tract infection, urethral surgery is avoided when an obstruction can be relieved by retrohydropropulsion or catheterization. Urethrotomy can be performed in the prescrotal or perineal regions depending on the level of the urethral obstruction. Although urethrostomy can be made in the perineal and antepubic positions, scrotal urethrostomy is the procedure of choice provided the lesion is distal to this area. Specific urethrotomy and urethrostomy procedures are described, including discussion about selection of the appropriate procedure for the urethral problem, patient stabilization considerations, general postoperative management, and risk of complications.