Perineal urethrostomy (PU surgery) reroutes the urethra to create a wider opening for urine to pass through. In dogs, it's most commonly performed on male dogs who suffer recurrent urethral blockages from bladder stones or have urethral strictures that can't be managed any other way. The surgery creates a new, wider urinary opening that prevents future blockages.
The average cost of dog perineal urethrostomy surgery is $2,500, with most owners paying between $1,500 and $3,500.
How Much Does PU Surgery Cost?
| Procedure | Cost Range | Notes |
|---|---|---|
| Scrotal urethrostomy (most common in dogs) | $1,500–$3,500 | Creates wider opening in the scrotal/perineal area |
| Perineal urethrostomy (higher location) | $2,000–$4,000 | Higher rerouting — for more proximal strictures |
| PU + stone removal (cystotomy combined) | $2,500–$5,000 | Both PU and bladder stone removal in one surgery |
| PU revision (previous PU failed) | $2,500–$5,000+ | More complex — revision of failed or narrowed PU |
Cost Breakdown
| Component | Cost |
|---|---|
| Exam + urinalysis + urine culture | $100–$250 |
| X-rays (locate stones/strictures) | $150–$350 |
| Contrast urethrogram (assess urethral anatomy) | $200–$500 |
| Pre-surgical blood work | $80–$200 |
| Anesthesia + monitoring | $200–$400 |
| PU surgery | $1,500–$3,500 |
| Neuter (if intact — usually required) | $200–$500 |
| Urinary catheter + collection system | $50–$150 |
| Overnight hospitalization (1–3 nights) | $200–$500/night |
| Take-home pain medication + antibiotics | $40–$100 |
| E-collar | $15–$40 |
| Follow-up visit (catheter removal, suture check) | $50–$150 |
| Total | $2,785–$6,140 |
When Do Dogs Need PU Surgery?
- •Recurrent urethral blockage: Male dogs who have been blocked 2+ times despite dietary management. PU prevents future blockages.
- •Urethral stricture: Narrowing of the urethra from scar tissue (from previous catheterization, trauma, or inflammation).
- •Recurrent stone obstruction: Stones that keep forming and lodging in the urethra despite treatment.
- •Urethral trauma: Severe injury to the urethra that can't be repaired normally.
- •Persistent urethral plugs: Mucus and crystal plugs that repeatedly block urine flow.
Cost by Clinic Type
| Clinic Type | Price Range |
|---|---|
| General practice vet (experienced in urinary surgery) | $1,500–$3,000 |
| Board-certified surgeon | $2,000–$3,500 |
| Emergency hospital (acute blockage) | $2,500–$5,000+ |
| Teaching hospital | $1,200–$2,500 |