A urethral stent is a thin mesh stent that is placed in patients that are struggling to urinate or are unable to urinate due to urethral, bladder, or prostate cancer. Medical treatment for the underlying cancer involves chemotherapy and radiation. Urethral stents are a palliative measure to immediately improve the flow of urine in patients that are unable to urinate. Not every patient is an appropriate candidate for this procedure and careful selection is required.
Why it’s done
Your veterinarian may recommend a urethral stent if your pet has:
- A known history of urethral, bladder, or prostate cancer
- Is struggling or unable to urinate
How to prepare for your pet’s procedure
Before your pet’s procedure, you will meet with one of our specialists to talk about the procedure and what to expect.
When you meet with our team, please bring a list of all medications that your pet is currently taking, including over the counter medications, vitamins, and herbal supplements. Before your pet’s procedure, you may be asked to discontinue giving certain medications that can increase the risk of bleeding.
This is a good time to ask questions about the procedure and make sure you understand the risks and benefits.
Preoperative diagnostics and tests
Before your pet’s urethral stent procedure the following may be indicated:
- Abdominal ultrasound
- Comprehensive blood tests
- Urinalysis and urine culture
- Urethral or prostate biopsy
General Instructions for the Day of Surgery
- Give your pet nothing by mouth after midnight the night before. This means that all food and water should be withheld.
- Please arrive for pet’s admission promptly at your scheduled arrival time.
- You will be asked to sign both a Surgical Consent Form as well as an Estimate, indicating your understanding of the procedure, risks, and associated costs.
What happens during a urethral stent procedure?
Your pet will be given a general anesthetic. In females, a lighted instrument with a camera on the end, called a cystoscope, is used to help locate the opening of the urethra in the vagina. A small wire is passed through the scope up the urethra and into the bladder using direct visualization and a moving x-ray, called fluoroscopy. The borders of the tumor are then defined with a dye study and an appropriate sized stent is selected. The stent is on a small delivery catheter and is gradually released in the area that is narrow or blocked using fluoroscopy. The scope is then used to verify placement and patency of the urethra.
The process is similar in males, but does not usually require the use of a cystoscope. The tumor is mapped using dye and fluoroscopy. The stent is deployed in the narrow or blocked area using fluoroscopy. Patency is confirmed with a second dye study.
The placement of a urethral stent is a salvage procedure for patients with severe symptoms and is intended to improve their quality of life. Patients may experience both immediate and delayed complications as a result of the procedure. Complications associated with urethral stenting can include the following:
- Bloody urine
- Increased risk for urinary infections, both immediate and lifetime
- Urinary incontinence: o The size of the stent is carefully measured for optimal results in each patient, due to a variety of factors including tumor size, length of urethra, and patient conformation, placement of a urethral stent may lead to urinary incontinence.
- Discomfort or straining while urinating: o Due to the physical nature of the stent placement within the urethra, patients will often still exhibit both increased frequency and straining to urinate.
- Stent fracture
- Stent migration
- Tumor ingrowth: o Ingrowth of the tumor may develop at either end of the stent within weeks to months following the procedure. New tumor growth can be removed in some cases, but may pose an irreversible life threatening complication in some patients.
After the procedure
- Following the procedure, you will be given a phone call with an update on your pet’s recovery. A scheduled discharge will be coordinated at that time.
- Please remove the bandage from your pet’s intravenous catheter site 10 to 15 minutes after arriving home.
- Some abdominal tenderness is common for 3-5 days following placement of a urethral stent.
- It is important to restrict your pet’s activity for the next 3-5 days while your pet is healing. Walks should be short and your pet should always be on a leash. Please do not let your pet rough house with other animals during this time.
- Many patients will not eat the night following anesthesia. If your pet has not eaten after 24 hours of returning home, please call Salt River.
- Some patients will vomit or have diarrhea following anesthesia. If the vomiting or diarrhea persists more than 24 hours, please call Salt River. In contrast, some patients may be constipated or may not have a bowel movement for up to 72 hours following anesthesia. If your pet is straining to defecate after 72 hours, please call Salt River.
- Suture removal is not necessary since no incisions are made.
- Scooting and more frequent urinations are common for 1-3 days following the procedure, but generally improve with each passing day. If the issues continue beyond 3 days, please call Salt River.
- An e-collar may be necessary if your pet is licking at its penis or vulva excessively.
Samples may be submitted to a number of specialized laboratories for evaluation including the following tests:
- Bacterial cultures
The final culture results can take up to 7-10 days. Once the final results have returned and a treatment plan has been devised, our specialists will call you to discuss the findings and recommendations.
A recheck appointment is required 7-10 days following the procedure.
Patients will still require lifelong medical therapy to manage their cancer following the placement of the stent. The urethral stent is a measure to improve quality of life but is not a guarantee that it will eliminate all medications or follow-up examinations.