Iatrogenic Urethral Trauma During Routine Prescrotal Orchiectomy in a Dog

A 6-month-old neutered male redbone coonhound was presented for a 2-day history of progressive subcutaneous swelling that began immediately following a routine prescrotal orchiectomy. Severe, fluctuant swelling and bruising of the ventral thorax, abdomen, scrotum, and right pelvic limb was apparent on examination. No evidence of an underlying coagulopathy was detected. Azotemia and hyperkalemia were noted on venous blood gas analysis. Analysis of the serosanguineous fluid obtained from the fluctuant swelling revealed a BUN, creatinine, and potassium that were severely elevated and consistent with urine extravasation. A retrograde contrast urethrogram was performed and revealed leakage of contrast at the level of the prescrotal urethra. The dog was taken to surgery and a 2-cm longitudinal urethral defect was noted at the level of the prescrotal incision. A scrotal ablation and urethrostomy was performed, and the dog recovered uneventfully. This case highlights the diagnostic workup of a case of subcutaneous urine extravasation secondary to a urethral laceration sustained during a routine prescrotal orchiectomy. Iatrogenic urethral trauma should be considered as a differential diagnosis in dogs presenting for subcutaneous swelling with a history of recent orchiectomy surgery.