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Posted by Pam on Mon, Oct 04 2021 at 04:16 PM CDT:

In Reply to: How did the cat urinate after that? posted by nm on Mon, Oct 04 2021 at 11:12 AM CDT:

"Perineal urethrostomy is a surgical procedure that is performed on males to create a permanent opening into the urethra through an incision in the skin of the perineum."

Cats can develop crystals in their urine, which in male cats can block the urethra because it is so narrow. This is usually caused by a diet high in ash content, which is now something that is adjusted in cat foods and there are special cat foods for those with a history of this issue. In the 70s the OTC cat foods were not properly balanced and this was a major concern for male cats. The crystals could block the urethra, causing either kidney failure or bladder rupture ... sometimes within just hours.

Usually we would place a catheter for several days, medicate and change the diet. If the issue returned then we often did the PU surgery. Thankfully current diets make this surgery very rare.

So, the penis is removed because the urethra is so narrow there. A new, permanent opening is made in perineum, suturing the urethra in place, offering a larger opening at the end of the urethra and a straight line from the bladder. Crystals may still form, but they can pass without danger of blockage/death. If the surgery is done well the cat will have full control of his urine, although sometimes there was some leakage/dripping during the weeks of healing.

I worked at a veterinary hospital when my own cat developed this issue, and assisted in his surgery (as well as at least 100 other cats over the years). He was younger, about 4, at the time. He came through the surgery very well, although DH was emotionally scarred! We had an observation window for the brave pet owners, but DH wouldn't even be in the building (yes, he went to a bar). Murph lived to be 17 years old in perfect health, on the special diet. DH still tells people about "his" cat's surgery and how he had a sex change (not really, but that is what DH thinks).

So, you can imagine his terror in those moments when he thought his urologist was suggesting a "whole up" surgery for him! We are going to Mayo Clinic and I am certain they are going to get a good laugh when we tell them about the VR error and DH's reaction. And hopefully they will update VR to understand HoLEP procedure!

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