Fluoroscopy-guided balloon dilation of a proximal urethral stricture caused by a urethral membrane in a female cat

Rincon Alvarez, Javier; Smith, Victoria; Broome, Cameron

Urethral balloon dilation is a common treatment modality for urethral strictures in humans, with similar outcomes to transurethral urethrotomy. The main complication is recurrence of the stricture in up to 25% of patients within the first 3 years. 29 Urethroplasty offers the greatest chance for cure in humans and remains the gold standard in management of urethral strictures. 6, 30 In veterinary medicine, limited cases of non-malignant urethral strictures have been reported in dogs 2,7,31,32 and cats. 5, [17] [18] [19] To our knowledge, no other feline cases managed by balloon dilation have been reported. Only two of the canine cases reported were managed by fluoroscopy-and cystoscopy-guided balloon dilation, 2,31 with no associated complications or signs of re-obstruction noted 22 months post treatment. In the current case, follow-up retrograde urethrography showed persistent mild narrowing of the previous stricture site; however, there was normal flow of contrast into the bladder and resolution of clinical signs. This was considered a good outcome and repeat dilation was not necessary. The placement of stents, self-expanding metallic stents (SEMS) and balloon-expandable metallic stents have been reported as treatment for urethral strictures and malignant urethral obstructions in both dogs and cats. Ureteral obstruction is the main concern with placement of SEMS for proximal urethral obstructions in cats, owing to a more caudal entrance of the ureters in the area of the trigone; 17,18 therefore, balloon dilation was the preferred treatment choice in this case.