Urethral Prolapse Dog: Cause, Symtoms and Treatment

What is Urethral Prolapse?

Urethral prolapse, also known as urethral eversion or urethral hyperplasia, is a medical condition that can occur in male dogs. It involves the protrusion or turning inside-out of the lining of the urethra, which is the tube that carries urine from the bladder to the outside of the body.

This condition is more common in certain breeds, such as Bulldogs, Boston Terriers, and English Bulldogs, but it can occur in any male dog. It is most commonly seen in young to middle-aged dogs, and neutered males are more commonly affected than intact males.

How Common is Prolapsed Urethra in Dogs?

Urethral prolapse is considered a relatively rare condition in dogs, but it can still occur. 

In male dogs, brachycephalic breeds (short-nosed breeds) such as Bulldogs, Boston Terriers, and Shih Tzus, are more commonly affected. In female dogs, breeds like Bulldogs, Boxers, and Dachshunds may have a higher incidence of urethral prolapse.

Prolapse is more commonly seen in young to middle-aged dogs. Neutered male dogs may also be more susceptible to this condition.

Urethral prolapse is relatively rare in male dogs compared to females. 

What Causes Urethral Prolapse in Dogs?

In Male Dogs

The main contributing factors in male dogs are:

• Straining to urinate: Frequent and forceful straining during urination can put excessive pressure on the urethra, leading to its prolapse.
• Chronic coughing: If a male dog has a persistent cough, such as in cases of respiratory infections or heartworm disease, the continuous abdominal pressure from coughing can contribute to urethral prolapse.
• Prostate issues: Enlargement of the prostate gland (benign prostatic hyperplasia or prostatitis) can lead to urethral prolapse in male dogs.

In Female Dogs

Urethral prolapse is more common in female dogs, especially those that are young and not spayed. The main contributing factors in female dogs are:

• Hormonal changes: Estrogen, the female hormone, plays a role in maintaining the integrity of the urethral tissues. Young, intact female dogs experience hormonal fluctuations during their estrus (heat) cycle, which can weaken the urethral tissues and increase the risk of prolapse.
• Increased abdominal pressure: Similar to male dogs, factors like excessive straining during urination, constipation, or obesity can cause increased abdominal pressure and contribute to urethral prolapse.
• Prolapsed vagina: In some cases, a prolapsed vagina can be associated with urethral prolapse. When the vaginal tissue protrudes, it can lead to the urethra's prolapse as well.
• Inflammation or infection: Any condition that causes irritation or inflammation in the urethra may increase the risk of prolapse.

Symptoms of Urethral Prolapse in Dogs

Urethral prolapse is a medical condition where the inner lining of the urethra protrudes through the external urethral opening. It can affect both male and female dogs, but the symptoms and signs may differ between the two genders. Here are the symptoms of urethral prolapse in male and female dogs:

Symptoms of Urethral Prolapse in Male Dogs

The most noticeable sign of urethral prolapse in a male dog is a visible fleshy, pinkish-red mass protruding from the urethral opening (preputial orifice), which is the opening in the skin where the penis is located. This mass may look like a "donut" shape or a "rosebud" and is often moist and swollen. The dog may experience discomfort or pain when trying to urinate, leading to difficulty urinating and potential blood in the urine. The dog may show signs of discomfort and may lick the affected area frequently.

In Female Dogs

Female dogs with urethral prolapse will have a visible mass at the external genital area. The exposed mass may also produce a discharge, which can be clear or slightly bloody. The prolapsed tissue can partially block the urethra, leading to difficulty in passing urine, increased frequency of urination, and straining during urination. The dog may exhibit signs of discomfort and may lick the affected area frequently.

How Do You Fix a Prolapsed Urethra in Dogs?

The treatment of a prolapsed urethra in dogs depends on the severity of the condition. 

Less Severe 

In less severe cases, where the prolapse is small and the dog is not in significant discomfort, your veterinarian may try conservative management. This may involve gentle cleaning of the exposed tissue and the application of topical ointments to reduce inflammation and irritation. 

If the prolapsed tissue is relatively small and has occurred recently, your veterinarian may attempt manual reduction. This involves carefully and gently pushing the protruding tissue back into its original position. After reduction, your dog will still require close monitoring and possible medical management, including antibiotics, anti-inflammatories, and pain relief medications. 

Medication Recommendations

Puainta® Diuretics-Hydrochlorothiazide Tablets

Difficulty in urination Urinary retention Urinary tract infection Frequent urination and blood in urine Prevention of urolithiasis

Puainta® Treatment of Urinary lnfection

Urodynia Urinary tract infection Urolith

More Severe or Chronic Cases

In more severe or chronic cases of urethral prolapse, surgery is often the preferred and more effective treatment option. The specific surgical procedure will depend on the size of the prolapse, the health of the surrounding tissues, and the individual dog's condition. The surgical options may include:

• a. Urethral Prolapse Excision: The protruding tissue is surgically removed, and the healthy tissues are sutured back together to close the urethral opening.
• b. Urethropexy: This procedure involves securing the urethra in a fixed position to prevent future prolapses. Various techniques can be used to achieve this stabilization.
• c. Castration: In male dogs with recurrent urethral prolapse, castration (neutering) may be recommended. Reducing testosterone levels can help prevent future prolapses in some cases.

How Much Prolapsed Urethra Dog Surgery Cost?

On average, the cost of prolapsed urethra surgery can range from $500 to $3,000 or more.

Conservative management and medical treatments may be less expensive initially, but if surgery is required, it can add to the overall cost. The surgical procedure itself may involve anesthesia, surgical supplies, hospitalization, and post-operative care, all of which contribute to the final cost.

Recovery of Urethral Prolapse in Dogs

If your dog undergoes surgical intervention to correct a prolapsed urethra, your dog may need to stay in the veterinary hospital for a day or two, where the veterinarian will keep an eye on the surgical wound and may prescribe medications such as antibiotics, anti-inflammatories, and painkillers to help with the healing process and control any discomfort.
Once the treatment is complete, you can take your beloved dog home. Your veterinarian will provide you with advice on how to properly monitor and care for your companion after treatment.
For example:

• It is important to keep your dog calm and limit his exercise, especially jumping and running, and avoid strenuous activities that may put pressure on the surgical site.
• Taking medication on time, always following the instructions on the prescription and possibly with food as advised by your vet.
• Prevent your dog from touching or licking the surgical wound by wearing an Elizabethan collar for your dog.
• On a daily basis you will need to closely monitor your dog's incision site and overall progress during recovery. Keep an eye out for signs of infection such as swelling, redness, increased discharge or excessive licking of the surgical area. If you notice any relevant symptoms, contact your veterinarian immediately.
• Your veterinarian will schedule a follow-up visit to monitor your dog's recovery progress and ensure that all is well. 

Can a Dog Bleed Out From a Prolapsed Urethra?

Yes, in severe cases, a dog with a prolapsed urethra can potentially bleed out if the condition is left untreated. Urethral prolapse involves the protrusion of the inner lining of the urethra through the external urethral opening. The exposed tissue can be delicate and prone to injury, which may result in bleeding.

Is Urethral Prolapse Painful for Dogs?

Yes, urethral prolapse can be painful for dogs.  The exposed tissue is sensitive and can be easily traumatized, leading to pain and discomfort for the affected dog.
Some dogs may show obvious signs of discomfort, such as vocalizing, restlessness, or difficulty finding a comfortable position. Others may exhibit more subtle signs, such as decreased activity, reluctance to move, or excessive licking of the affected area.