Scrotal urethrostomy for the salvage of a dog with severe urethral constriction

An eight-year-old Spitz male dog with the complaint of dysurea was brought for the treatment. The history revealed that the animal had the problem of dysuria and stranguria for the last one month. The animal had been operated upon for penile urethrotomy by a veterinarian to remove calculi without success. Palpation of the abdomen revealed a tense bladder occupying almost whole of the abdomen. Animal had tachycardia and tachypnoea with signs of dehydration and apparent stress. The attempts to catheterize the bladder were futile. Plain radiography showed the presence of a small calculus with very less radiographic density. Urethrotomy was performed and a small calculus about 5 mm in diameter was retrieved from the urethra in the caudal part of os-penis. The urethra was catheterized and the wound was closed in standard manner. Animal removed the indwelling catheter 2 days later, which was re-catheterized. Animal removed the catheter again but the owner brought the animal 3 days later and this time the catheter could not be passed, however, the animal passed the urine through urethral orifice. It was decided to allow urethral healing without catheterization. Leakage of urine from the operation site started after 2 days and continued till day 15, when the animal was brought to the clinics again. Animal was passing only small quantity of urine through the natural urethral orifice and urine had started to accumulate subcutaneously around the incision site. Contrast radiography of the urethra revealed the presence of stricture in the urethra. It was decided to perform urethrotomy to fix the indwelling catheter again. The animal was under serious stress and developed cyanosis as the diazepam was administered for pre-anaesthetic medication. The animal was revived by administration of oxygen and urethral surgery was postponed. However, tube cystostomy was performed using a Foley's catheter to facilitate the drainage of urine under local infiltration analgesia. After a week's time the animal appeared quite alert and active and was passing the urine through Foley's catheter. It was then decided to perform urethrotomy and dilate the constricted part of the urethra by passing a catheter. On surgical opening of the urethra it was observed that about 2 inch long urethra had become fibrosed and constricted and it was not possible to dilate the urethra. As a last attempt scrotal urethrostomy was performed after the ablation of the scrotum. The animal maintained good health thereafter without any problem in micturition. It was concluded that scrotal urethrostomy is a simple procedure and can be used to salvage the dogs with irreparable damage to the penile urethra.