Cost and Complications of Perineal Urethrostomy in Cats

My feline son Ziggy has always been prone to problems with his urinary tract. He frequently ends up with mineral crystals that block his urethra, making it impossible for him to pee--and necessitating an expensive vet visit. His problems persisted despite a prescription diet, lots of water, and stress-reducing medicine, so, after his third emergency treatment, his vet informed me that he would need a perineal urethrostomy. A perineal urethrostomy (often shortened to P.U.) is a surgery that involves amputating a cat's penis and widening his urethra to prevent recurrent blockages.

I talked to the vet at length about this surgery, which is usually only performed on cats who develop recurrent urinary blockages. Although it's worth it for cats like mine who often end up with urinary crystals, the surgery is costly, and some cats have complications from it. The upfront financial cost of a perineal urethrostomy for a cat varies depending on the surgeon, but veterinary surgeons in my area charge anywhere from $3,900 to $9,200 for the procedure. If there are only a few veterinary surgeons in your area, your options may be limited and you may have to go with the higher-end cost.

This may seem ridiculously expensive, but considering that treatment for a blockage can already cost that amount if your cat needs to be hospitalized and catheterized, perineal urethrostomy is a surgery that "pays for itself" within a year or two if you have a cat who is especially prone to a blocked urethra. It can also be a life-saving surgery, since it prevents blockages that, left untreated, can often kill a cat in as few as 48 hours.

The complications of perineal urethrostomy are generally mild; serious problems are rare. My vet said that, very rarely, cats will die from complications of anesthesia. However, vets are very careful these days and monitor cats throughout surgery for signs of anesthesia complications. It's extremely unlikely that a cat would die from anesthesia after a perineal urethrostomy.

The most common complication of perineal urethrostomy is urinary tract infection. Luckily, the kinds of UTIs that a cat will get after perineal urethrostomy are minor compared to the kind a cat would get before the operation. They will no longer block the cat's urinary tract, but they will require treatment with antibiotics. It's also not too uncommon for a cat's urethra to heal shut within a few weeks of surgery. If you see your cat straining to pee after the operation, he may need to have the vet gently cut his urethra again so he can keep peeing.

Lots of common symptoms look like complications of perineal urethrostomy in cats, but they're not really. It's totally normal for a cat to bleed from his urethra for a couple of weeks after the operation. However, foul-smelling urine or pus and drainage at the site of the incision, could indicate an infection and these symptoms need to be evaluated.

Overall, the costs and complications of perineal urethrostomy are pretty serious, and that's why it's a surgery reserved only for cats who get urinary problems despite appropriate care. If you're considering perineal urethrostomy for your own cat, make sure you talk to your vet to help analyze the benefits and risks of this procedure.