Outcomes and postoperative complications after transpelvic urethrostomy used as first-line surgery in 38 male cats with obstructive lower urinary tract disease

Objectives This article aimed to report on the short- and long-term outcomes after transpelvic urethrostomy (TPU) as a first-line surgery to treat obstructive lower urinary tract disease (OLUTD) in male cats. Methods A retrospective review and follow-up owner telephone questionnaire for cats with OLUTD undergoing TPU as a first-line surgery between 2013 and 2019, at a single referral hospital, were performed. A minimum follow-up period of 1 year was required to be included in the study. Short- and long-term complications were defined as those that occurred, respectively, within or after the first 4 weeks postoperatively. Results Thirty-eight male cats were included. The short-term complication rate was 18%. Idiopathic lower urinary tract disease (ILUTD) and stomal stenosis (SS) were the two most frequent short-term complications. Long-term complications were reported in 34% of the cats and included ILUTD, urinary tract infection and SS. The mortality rate was 5%. Eighty-two percent of the owners were satisfied with the postoperative outcome. The most common reason for owner dissatisfaction was the occurrence of SS, especially because these complications required multiple surgical revisions to be definitively managed. The long-term quality of life was considered to be good to very good by 89% of the owners. Ninety-one percent of the cats were free of clinical urinary signs at the time of the questionnaire completion. Conclusions and relevance TPU can be an acceptable first-line surgical technique to treat cats with OLUTD. Most cats experienced a good to very good quality of life after TPU. Most complications were transient or manageable medically. Most of the major complications were SS, which can be technically challenging to address and may require multiple revision surgeries.