In animals with anatomic urethral obstruction, the size and nature of the lesion can usually be determined by retrograde positive-contrast-enhanced urethrography. The prevention of renal damage secondary to urinary obstruction and the relief of urinary obstruction to prevent detrusor atony resulting from overdistention are the main priorities in dogs and cats with urine outflow tract obstructions. If the obstruction is created by a urethral urolith, retropulsion of the urolith in the bladder may be successful. If the urolith cannot be moved by retropulsion, a temporary or permanent perineal urethrosthomy may be necessary.
In dogs with benign prostatic hyperplasia resulting in urethral obstruction, castration usually leads to a rapid decrease in the size of the prostate. The use of estrogens to decrease prostatic size is not recommended because of the potential for systemic adverse effects and squamous metaplasia of the prostate. Surgical drainage and marsupialization may be necessary to manage prostatic abscesses or prostatic cysts.
In some cases of prostatic neoplasia, partial or complete prostatectomy may be beneficial; however, this surgery is difficult and frequently results in neurologic damage and urethral sphincter incompetence.
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