Perineal Urethrostomy (PU) in Cats

What It Is, Why It's Needed, What to Expect, and How We Support You

Why Might Your Pet Need This Surgery?

A Perineal Urethrostomy (PU) is a surgical procedure performed on male cats with recurring or life-threatening urinary obstructions. It creates a new urinary opening that bypasses the narrow portion of the urethra in the penis, reducing the risk of future blockages.

This procedure is typically recommended when:

  • A cat has experienced multiple urethral obstructions
  • Obstruction cannot be relieved by catheterization
  • There is scarring, stricture, or trauma in the urethra
  • Long-term quality of life is compromised without surgery

Referrals Required for This Surgery

Our hospital does not provide diagnostic or consultation services for a perineal urethrostomy. Instead, your pet’s care is transferred to us once a referring veterinarian has performed the diagnostic workup and recommended surgery.

We require a referral for the following reasons:

  • The decision to pursue surgery should be made with your primary veterinarian, who knows your pet's medical history, has completed the necessary diagnostics (such as x-rays or ultrasound), and can discuss the full range of treatment options with you.
  • Our surgical team's role begins after surgery has been advised. We do not offer in-clinic imaging, diagnostics, or pre-surgical consultations.
  • A referral allows us to prioritize patient safety by reviewing complete records and understanding the medical background before proceeding with anesthesia and surgery.

What qualifies as a referral?

We're flexible. A referral can be as simple as:

  • A shared set of medical records from your veterinarian
  • A treatment plan indicating that surgery has been recommended
  • A brief summary emailed, texted, or faxed from your vet's team
  • Direct communication between our team and your rDVM

Our team will review the records in advance, and if we have any questions, we'll reach out directly to the referring clinic.

If you're a pet owner, please talk with your veterinarian first about whether surgery is the right option. Once that decision is made, we're here to provide safe, compassionate, and efficient surgical care.

What Does the Surgery Involve?

PU surgery involves removal of the narrow penile portion of the urethra and creation of a wider permanent opening (stoma) just below the anus. This reduces resistance to urine flow and helps prevent future obstructions.

The procedure is performed under general anesthesia with sterile technique, and requires detailed post-operative monitoring and care.

Are There Alternatives?

In some cases, temporary urinary catheterization and medical management may provide permanent relief, but recurrence is common. Diet, medication, and hydration strategies can help—but when obstruction becomes recurrent or severe, PU surgery is the most effective and humane solution.

What Are the Benefits?

  • Resolves life-threatening urinary blockages
  • Prevents recurrence of obstruction in most cases
  • Improves long-term quality of life and comfort
  • Reduces emergency visits and catheterization trauma

What Are the Risks?

  • Anesthetic complications
  • Post-op straining, bleeding, or urinary incontinence
  • Infection or surgical site dehiscence
  • Scar tissue formation or stricture at the new opening
  • Risk of continued urinary issues in some patients including Urinary Tract Infection (UTI)
  • Inappropriate Urination – Pets may develop behavioral changes or difficulties related to urination, such as urinating in unusual locations.

What's Included in Our Surgical Care

Perineal Urethrostomy Surgery Package: $1,235.00

Price includes:

  • A personalized anesthesia plan with multimodal pain control
  • IV catheter placement and fluids
  • Anesthesia and multiparameter monitoring
  • PU surgery using standard dissection and suture closure
  • Post-op stabilization and in-clinic recovery
  • Take-home medications (pain control and antibiotics)
  • Discharge instructions and recovery plan

When Additional Care Is Needed

In some cases, pets require more intensive or ongoing care after surgery. Because we are an outpatient only clinic, transfer to an overnight hospital may be recommended.

Pets may need overnight care, especially if:

  • They experience excessive post-operative bleeding or straining
  • They require IV pain medications or extended sedation
  • They require further stabilization due to electrolyte imbalances.

If this happens, we will coordinate a transfer to an emergency or specialty facility, and any costs associated with that transfer and continued care will be the owner's responsibility.

Aftercare: What to Expect at Home

Your pet will go home with:

  • Prescription medications for pain and infection control
  • Instructions for activity restriction and wound care
  • Details on when to return for recheck or suture removal

Most pets start to feel better quickly once the infection is removed, but healing takes time. We're here to help every step of the way.

Have Questions?

Please reach out to our team. We are happy to review records, coordinate with your veterinarian, and guide you through this process.