Contributors: Andrew Gardiner, Elisa Mazzaferro
Species: Feline | Classification: Diseases
Introduction Pathogenesis Diagnosis Treatment Outcomes Further Reading
Introduction
- Uncommon.
- Cause: hit by car (HBC), ballistic impacts, bite wounds, malicious intervention (occasionally).
- Signs: severe hemorrhage, urethral obstruction, dysuria.
- Treatment: simple repair with sutures to penile amputation Penis: amputation depending on severity.
Presenting Signs
- Severe hemorrhage - lacerations involving cavernous tissue.
- Urethral obstruction/dysuria - more chronic cases Urethra: obstruction.
Acute Presentation
- Acute presentations always warrant complete physical examination as other injuries are likely especially following HBC and ballistic injuries.
Cost Considerations
- Potential loss as stud may see significant financial loss.
Special Risks
- Always consider other more serious injuries before inducing anesthesia General anesthesia: overview.
Pathogenesis
Etiology
- HBC, ballistic impacts, bite wounds, malicious intervention (occasionally), blunt trauma.
Pathophysiology
- Acute trauma by whatever cause lacerates and damages tissue causing hemorrhage which may be profuse and may result in loss of the continuity of the urethra. This causes urine to pass into the penile parenchyma where it adds to tissue necrosis.
- Penile trauma and lacerations involving cavernous tissue result in severe hemorrhage.
- More chronic injuries may cause urethral obstruction and dysuria.
- Crush injuries may result in laceration of cavernous tissue.
Diagnosis
Presenting Problems
- Penile hemorrhage.
- Dysuria.
Client History
- Penile hemorrhage.
- Dysuria (more chronic injuries).
Clinical Signs
- Obvious damage to penile parenchyma on examination Penis and sheath: clinical examination.
Diagnostic Investigation
Other
- Clinical examination Penis and sheath: clinical examination: gross damage to tissue of penile area, bruising, swelling, laceration of tissue.
Radiography
- Contrast urography may demonstrate loss of integrity of urethra Radiography: intravenous urography.
Differential Diagnosis
- Urolithiasis may cause urethral rupture Urethra: rupture and subsequent tissue necrosis Urolithiasis.
Treatment
Initial Symptomatic Treatment
- Suturing of fresh lacerations.
- Anatomical repair of lacerated urethra will be difficult due to small size but should be effective if repair technique is of a high standard. Risk of stricture.
Suture material chosen should evoke minimum inflammatory response, eg polyglactin is preferred to catgut, in order to minimize risk of stricture. - Severe damage may necessitate amputation of the penis Penis: amputation.
Standard Treatment
Simple lacerations of mucosa
- Digital pressure/repair with fine sutures.
Gross disruption of cavernous tissue
- Amputation of penis with perineal urethrostomy Penis: amputation Urethrostomy.
Outcomes
Prognosis
- Generally favorable provided there is no imperative that the animal be suitable for breeding.
Expected Response to Treatment
Reasons for Treatment Failure
- Failure to diagnose urethral rupture.
- Post-operative stricture following urethral repair.
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Corgozhino K B, de Souza H J, Pereira A N et al (2007) Catheter-induced urethral trauma in cats with urethral obstruction. J Fel Med Surg 9 (6), 481-486 PubMed.
- Degner D A & Walshaw R (1996) Healing responses of the lower urinary tract. Vet Clin North Am Small Anim Pract 26 (2), 197-206 PubMed.
- Lees G F (1996) Use of misuse of indwelling urethral catheters. Vet Clin North Am Small Anim Pract 26 (3), 499-505 PubMed.