Urethral Prolapse in Dogs

Urethral prolapse occurs when the inner lining (mucosa) of a dog’s urethra protrudes through the external urethral opening at the tip of the penis. It primarily affects young, unneutered males and is more common in brachycephalic (short-nosed) breeds such as English Bulldogs and Boston Terriers. While usually not life-threatening, it can cause discomfort and often requires veterinary attention.

What Causes Urethral Prolapse?

The exact cause is not fully understood, but several factors may contribute:

• Excessive Sexual Excitement: Frequent or prolonged erections and arousal may play a role.
• Increased Intra-Abdominal Pressure: Conditions that cause straining—such as brachycephalic syndrome, chronic coughing, or straining to urinate or defecate—can increase abdominal pressure and contribute to prolapse.
• Urinary Tract Issues: Urethral infections (urethritis) or urinary stones (uroliths) can irritate the urethra and trigger prolapse.
• Developmental Abnormalities: Anatomical differences or tissue weakness in some dogs may increase susceptibility.

Recognizing the Signs

Urethral prolapse often appears as a small, red or purple, pea-sized mass protruding from the tip of the penis. It may be visible only during an erection or present all the time.

Other signs include:

• Excessive Licking: Persistent licking due to irritation or discomfort.
• Bleeding: Blood in the urine (hematuria) or bleeding from the tip of the penis.
• Straining to Urinate (Stranguria): Difficulty or effort when urinating.
• Urinary Blockage: In rare, severe cases, swelling or damage to the tissue can cause complete blockage—a life-threatening emergency.

Diagnosis

A veterinarian will usually diagnose urethral prolapse through a physical exam and visual inspection. Additional tests may be recommended to identify underlying causes or complications:

• Urinalysis and Urine Culture: To check for infection.
• Radiographs (X-rays) or Ultrasound: To detect urinary stones.
• Tissue Sampling (Cytology or Biopsy): To rule out other conditions such as tumors.

Treatment Options

Treatment depends on severity, recurrence, and whether pain or bleeding is present.

• Conservative Management: For mild cases with minimal discomfort or bleeding, manual reduction (pushing the tissue back into place) may be attempted, often with a temporary purse-string suture to hold it. However, recurrence is common.
• Surgical Correction: Preferred for recurrent, severe, or damaged cases. This typically involves removing the prolapsed tissue and suturing the healthy urethral lining to the tip of the penis. In some cases, a urethropexy—stitching the urethral lining to the penis’s external surface—is performed.
• Castration: Strongly recommended at the time of surgery, as reducing sexual excitement can help prevent recurrence.
• Addressing Underlying Conditions: Treat any infections, urinary stones, or other contributing issues.

Post-Operative Care and Prognosis

• Activity Restriction: Limit activity for several weeks to allow proper healing.
• Elizabethan Collar: Prevents licking or chewing at the surgical site.
• Medications: Pain relief, anti-inflammatories, and antibiotics are commonly prescribed.
• Monitoring: Mild bleeding or swelling may occur for a few days after surgery, but prolonged bleeding, difficulty urinating, or signs of infection require prompt veterinary attention.

The prognosis is generally good with appropriate treatment. However, recurrence is possible even after surgery, and additional surgical intervention may be needed in such cases.

If you see signs of urethral prolapse in your dog, contact your veterinarian promptly for diagnosis and treatment recommendations.