Pre-scrotal access for urethropreputial anastomosis in ten dogs: a new approach

ABSTRACT: Objective: To propose, evaluate, and describe a new approach to preputial urethrostomy using a pre-scrotal approach to minimize surgical trauma. Type of Study: Case series. Animals: Ten male dogs with lesions in the penile urethra or penis. Methods: Eight dogs had clinical signs of urinary obstruction, one had a necrotic penile lesion secondary to paraphimosis, and one presented with hemorrhage after an inadvertent pre-scrotal urethrostomy. They underwent a new preputial urethrostomy approach. Access to the urethral lumen, penile amputation, and acquisition of the internal preputial lamina for urethral anastomosis was achieved using a single access site in the pre-scrotal midline. Results: Even in the absence of the penis, the animals had jet urination and maintained the cosmetic appearance of the external preputial region. None showed signs of urethral stenosis, urinary incontinence, or contact dermatitis during the evaluated period (360 days). Two patients required subsequent intervention due to failure in restrictive home management, but the technique was successfully repeated. Conclusion: Pre-scrotal access favored the urethrostomy procedure by allowing the restoration of urinary flow and maintaining external preputial conformation, minimizing the risk of complications observed in traditional urethrostomies through a small incision. Clinical Significance: The preputial urethrostomy technique for pre-scrotal access is feasible and applicable in the surgical routine of dogs with obstructive lesions to the penile urethra and severe penile lesions. It minimizes the risk of complications observed in routine urethrostomy techniques, thus avoiding subsequent surgical interventions for resolution.