Surgical Management of Extensive Urine Extravasation Resulting in Urethrocutaneous Fistulation and Soft Tissue Necrosis of the Femoral Region Secondary to Pelvic Urethral Rupture in Two Cats

Pelvic urethral rupture is an uncommon but serious injury in cats that may result in extensive urine extravasation and severe soft tissue damage. This report describes the surgical management of two cats with pelvic urethral rupture complicated by urine extravasation extending into the femoral region, resulting in urethrocutaneous fistulation and extensive soft tissue necrosis. Two 2-year-old male domestic shorthairs presented with similar injuries, one undergoing retrograde urethrography, the other additional CT scan as well to define the extent of injury. In Case 1, transpelvic urethrostomy was performed following surgical debridement of necrotic tissue, and tension-relieving mesh incisions were subsequently made in the surrounding skin of the left thigh to reduce tension on the primary closure and facilitate closure of the skin defect created by debridement. In Case 2, prepubic urethrostomy and surgical debridement were performed following confirmation of pelvic urethral rupture, with contrast accumulation identified at the dorsal aspect of the ischiatic arch on CT. In both cases, the soft tissue wounds were managed by second-intention healing. Both cats recovered without major postoperative complications, and the soft tissue injuries had resolved successfully during follow-up. Both cases demonstrate that prompt surgical intervention combined with appropriate wound management can result in favorable outcomes in cats with pelvic urethral rupture complicated by extensive urine extravasation into the femoral region.