Dogs will require several weeks of restricted activity after an abdominal procedure. After cystotomy, the dog’s bladder will be slightly smaller for a few weeks because of the stitches, and they will likely have to urinate more often. They may have a sense of urgency to urinate, and accidents may occur. Blood tinged urine is common. (Active dripping of blood is not normal and should prompt you to call your surgeon.) The Elizabethan collar (Cone shaped collar) is left on for 10–14 days until the site is healed to prevent licking and chewing. Your dog will likely come home with oral pain medication. If a bladder infection is present, antibiotics will be prescribed. Stones are sent for analysis to determine whether special diets or medications are needed.
The tissue around the urethra has an excellent blood supply, and dogs may have bleeding for several days after a scrotal urethrostomy. Excitement or trauma to the area from licking can increase the risk of bleeding, so dogs must wear Elizabethan collars and may require sedation for several days to reduce the chance of bleeding.
Complications of urinary obstruction include tears in the urethra or bladder resulting in urine leakage, bladder dysfunction, incontinence, or scarring in the urethra that can cause recurrence of the obstruction. Postoperative complications after cystotomy include temporary bloody urine, urine leakage at the stitch line of the bladder or, hernia formation at the abdominal incision, and infection. Complications after scrotal urethrostomy include bleeding (in the first few days after surgery), irritation of the skin from urine, scarring/narrowing of the opening that can cause obstruction, irritation, urine spraying on the legs, and infection.
Recurrence of urethral obstruction by stones is prevented by reducing the factors that cause stone formation. If your dog is a stone former, you will need to follow your veterinarian’s diet and medication recommendations closely and have your dog rechecked as needed to make sure crystal formation is being controlled.
Prognosis is excellent for dogs that undergo cystotomy with or without scrotal urethrostomy for urethral blockage, as long as the dog has not suffered serious kidney or toxic damage from prolonged obstruction.