Urethral Reduction and Resection in Dogs

A urethral prolapse can occur, usually in young intact male dogs, causing the urethral mucosa to protrude. The protruding tissue is subject to irritation and infection from bacteria present in the environment. Although the condition may resolve itself spontaneously, it will usually recur and can become chronic. In these cases, intervention to manually reduce the prolapsed urethra and specialized suturing to restrict the urethral opening or resection of part of the prolapse to allow tissue to return to the urethral sheath may be performed by your veterinarian. Castration is also frequently recommended to accompany this procedure to prevent future problems with urethral prolapse.

Your dog should fast 12 hours prior to administration of general anesthesia for surgery. General anaesthetic will be administered to your dog intravenously and may be followed by gaseous anesthesia depending on the procedure to be used. If the prolapse is small, manual reduction by inserting a catheter, manipulating the prolapse back into the urethral sheath and placing a purse string suture at the external urethra orifice can be conducted to prevent tissue from extruding. This suture should be removed in 5 days. If surgical reduction and resection is required, once anesthetized, your dog will be placed on his back and the penis and pelvic area will have hair removed and be cleaned in preparation for surgery. The penis will be extruded and moved into a caudal position and secured out of the way. A sterile urinary catheter will be inserted into the urethra. An incision will be made at the base of the prolapse to excise some of the protruding tissues. At this time, only a portion is cut and repair by suturing of the remaining urethral mucosa is initiated. If all the prolapsed tissue is cut at once the urethral mucosa will retract into the penile tunic and will be difficult to suture. The incised urethral tissue is sutured to the penile tunic with small sutures 2 to 3 mm apart and from the inside urethral lumen to the outside. A simple continuous suture pattern is used. As repair is conducted, more prolapsed tissue is excised, and urethral mucous tissue attached to the penile tunic as the procedure proceeds. Excised tissue should be sent for laboratory analysis to rule out neoplasia. Once suturing has been completed your dog will be allowed to recover from anesthesia. Antibiotics, anti-inflammatories and analgesics will be administered at time of surgery. 

Urethral reduction and resection, accompanied by castration, has a good success rate at resolving urethral prolapse in young male dogs. However, recurrence is possible, especially if castration is not performed, and may occur in up to half of cases. The excised urethral tissue should be preserved and sent for analysis of tissue. If inflammation extends deeply in the tissue or necrosis and scarring are present, the condition is more likely to recur. If recurrence becomes a problem, penile amputation and scrotal urethrostomy may be required.

The catheter is usually removed immediately or shortly after the procedure. As long as the catheter is in place, it should be monitored to ensure it does not become dislodged. It will be critical to prevent your dog from licking, scratching or otherwise interfering with the penile area. An E-collar and careful monitoring will be required. There will be some bleeding from the site, however, if this becomes excessive or if discharge characteristic of infection occurs, obtain veterinary care immediately. Your dog will be given painkiller, anti-inflammatories, and antibiotics post-surgery. These should be given as directed by your veterinarian. Activity and exercise should be limited for one to two weeks and outdoor activity restricted to a leash. If absorbable sutures are used they will not require removal. Non-absorbable sutures require removal in seven to ten days.

The cost of the urethral reduction and resection ranges from $300 to $1,000 depending on the cost of living in your area and the invasiveness required during the procedure. If manual reduction and suturing resolve this condition, the cost may be lower. 

Hemorrhaging and infection are complications specific to this procedure for which your dog should be closely monitored post-surgery. Recurrence of prolapse is common and castration usually mitigates this.

As with any procedure, anesthetic presents a risk, especially for brachycephalic dogs that may already be experiencing respiratory disorders.

If you own a brachycephalic breed dog who is experiencing respiratory issues, addressing these issues through palate surgery or correction of stenotic nares may reduce intra abdominal pressure and mitigate urethral prolapse. Castration of dogs experiencing urethral prolapse may prevent future incidence.