Perineal Urethrostomy (PU Surgery)
A surgical reconstructive procedure in male cats that removes the narrow penile urethra and creates a permanent, wider urethral opening to prevent urinary obstruction.
💬 In Plain English
Perineal Urethrostomy (commonly known as PU surgery) is a life-saving reconstructive surgery performed on male cats that suffer from repeated, life-threatening urinary blockages (FLUTD). In male cats, the penile urethra narrows down to the diameter of a tiny needle at the tip of the penis, making it extremely easy for microscopic crystals, blood, and mucus plugs to lodge and cause fatal blockages. During a PU surgery, the veterinary surgeon amputates the narrow penis and sutures the wider, pelvic portion of the urethra directly to the skin beneath the anus. This gives the male cat a wide, female-like urethral opening, permanently ending recurrent blockages.
🔬 Clinical & Technical Depth
For Vets & TechniciansFormal Clinical Definition
Surgical excision of the feline penis and narrow penile/bulbourethral urethra with bilateral ischiocavernosus tenotomy, mobilizing the wider intrapelvic membranous urethra and creating a permanent stoma at the perineum.
Why Veterinarians Use It
Veterinarians perform PU surgery when male cats have suffered multiple recurrent urethral obstructions or severe distal urethral strictures that cannot be cleared with a catheter.
Clinical Context Encountered
Discussed with owners of male cats facing their second or third emergency hospital unblocking.
Clinical Reference Guide (Surgical Procedure)
Aftercare & Recovery
Strict E-collar use for 14 days; dust-free paper litter (no clay/clumping) to prevent litter granulate contamination; suture removal at 10–14 days.
- •An Elizabethan collar (cone) MUST stay on 24/7 until skin sutures are removed: even 30 seconds of licking can tear delicate mucosal sutures, causing severe scarring and complete urethral stricture.
❓ Questions to Ask Your Veterinarian
Take these actionable questions with you to your next clinic visit or appointment:
- 1Has the cat been stabilized and have high potassium levels (hyperkalemia) resolved before going into surgery?
- 2Why is it critical to use non-clay paper litter (like Yesterday’s News) for 2 to 3 weeks while the surgical site heals?
- 3How does PU surgery protect against blockages while slightly increasing the risk for simple, easily treatable bacterial bladder infections?
Academic & Clinical References
- ACVS Surgical Resource: Feline Urethral Obstruction and Perineal UrethrostomyOrganization: American College of Veterinary Surgeons (ACVS) • Accessed: 2026-01-10https://www.acvs.org