If your cat repeatedly has problems urinating, your veterinarian may recommend your cat get a perineal urethrostomy. Here's everything you need to know about PU surgery in cats and how it could help get their urinary system back on track.

Why Would My Cat Need a Perineal Urethrostomy?

Urinary blockages are a fairly common problem in cats, especially among male cats. A blockage can be caused by a lower urinary tract disease that leads to inflammation and swelling in the urethra, the tube that allow urine to pass from the bladder to outside the body. Stones, mucus plugs or tumors in the urethra can also cause blockages. If a cat can't urinate, their bladder swells up with urine. Not only is this extremely painful, but cats with urinary blockages are at risk of life-threatening damage to their bladder, kidneys and the rest of the body.

Most times, urinary blockages can be managed through a combination of a balanced meal plan, medicine, stress reduction, increased water consumption and/or the insertion of an emergency catheter. If your cat consistently has urinary blockages that can't be managed medically, however, they may be a candidate for PU surgery.

What Is PU Surgery in Cats?

PU surgery involves surgically opening the urethra and making a new, wider opening for the cat to pee from. It's a fairly simple procedure that has been performed for many years and has a good success rate. The surgery is done under general anesthesia, usually with a local nerve block, meaning your cat will be completely asleep during the surgery and pain-free during and after the procedure.

Potential Complications

Even though PU surgery in cats is successfully performed every day, complications can happen. Potential complications after surgery include the narrowing of the urethrostomy site, urine leakage under the skin, bleeding, urinary tract infections and incontinence, which is why it is so important to have this procedure done by an experienced surgeon and properly care for your cat after the surgery.

Another important fact to consider is that your cat's urinary problems can be due to an underlying disease, such as feline lower urinary tract disease. If the underlying condition isn't addressed, your cat may continue to strain while urinating, have bloody urine and/or pee outside the litter box — even after PU surgery.

Alternative Treatments

Transpelvic urethrostomy (TPU) is an alternative to PU. However, because PU is so successful, TPU is less common.

Nonsurgical treatment requires you to work closely with your vet to try and resolve the underlying cause of your cat's urinary blockages and to monitor your cat closely for signs of urinary obstruction. Unless you're watching your cat 24 hours a day, however, this is nearly impossible. There are few alternatives for cats who repeatedly develop blockages.