Urethral Plugs Research Articles

Research progress in female pelvic floor rehabilitation aids.

Pelvic floor dysfunction (PFD) is a common clinical problem that can lead to bladder and bowel dysfunction such as urinary incontinence, urinary retention, fecal incontinence, pelvic organ prolapse, and sexual dysfunction. Pelvic floor rehabilitation aids are essential tools in the treatment of PFD. However, there is limited understanding of the efficacy and mechanisms of these aids, and there is a lack of standardized guidelines for selecting appropriate aids for different types of PFD. To assist patients in choosing suitable pelvic floor rehabilitation aids to their needs, it is necessary to summarize the existing types, mechanisms, and applications of these aids. Based on their mechanisms and target functions, pelvic floor rehabilitation aids can be mainly categorized into 3 main types. The first type includes aids that improve pelvic floor function, such as vaginal dumbbells, vaginal tampons, and vaginal dilators, which aim to strengthen pelvic floor muscles and enhance the contractility of the urethral, vaginal, and anal sphincters, thereby improving incontinence symptoms. The second type consists of aids that mechanically block the outlet, such as pessaries, urethral plugs, incontinence pads, incontinence pants, anal plugs, and vaginal bowel control systems, which directly or indirectly prevent incontinence leakage. The third type includes aids that assist in outlet drainage, such as catheters and anal excreta collection devices, which help patients effectively expel urine, feces, and other waste materials, preventing incontinence leakage. By summarizing the existing pelvic floor rehabilitation aids, personalized guidance can be provided to patients with PFD, helping them select the appropriate aids for their rehabilitation needs.

Urethral obstruction in a Brazilian Shorthair cat

The objective of this study was to report a case of urethral obstruction in a neutered, three-year-old male Brazilian Shorthair cat. Urethral obstruction is a frequent and urgent urological issue encountered in veterinary clinics, typically affecting male cats due to the anatomical structure of their long and narrow urethra. This condition can be triggered by factors such as urethral plugs, urinary stones (uroliths), tumors, or muscle disorders. Certain factors like diet, low fluid intake, stress, obesity, and poor management can elevate the risk for these animals to develop uroliths, which can in turn cause urethral obstruction. Commonly observed clinical symptoms include excessive penis licking, perineuria, painful urination (dysuria), and frequent small urinations (pollakiuria). In this reported case, the cat demonstrated recurrent urinary retention and obstruction. Upon clinical examination, the cat appeared lethargic, dehydrated, and showed normal coloration with significant abdominal tenderness. Its bladder was distended and firm to the touch. The patient was stabilized and underwent a relieving cystocentesis. Following this, the cat was hospitalized and a urethral catheterization was performed to remove the obstruction. However, later in the day, the condition recurred, and a cystotomy was conducted. The study concludes by emphasizing that quick and accurate diagnosis is crucial in minimizing the harmful effects caused by urethral obstruction. Furthermore, decisive and personalized treatment is key to maintaining the animal's quality of life, wellbeing, and overall health.

Manejo anestésico do felino obstruído: Relato de caso

Feline Lower Urinary Tract Disease (FLUTD) is the main cause of urethral obstruction in this species, including idiopathic obstructions, urethral plugs, urolithiasis and other mechanical obstructions, such as strictures and neoplasms. This predominance is directly related to young and middle-aged males, due to the male's urethra being longer and narrower, increasing the likelihood of interference. Clinical signs often include hematuria, polyuria and, most importantly, stranguria, along with a full bladder. In more severe cases, cardiovascular instability and azotemia may occur. The diagnosis of FLUTD is made through a physical examination of the patient, which may reveal bladder dilation, a history of difficulty urinating, with several visits to the litter box, and there may or may not be vocalization. The goal of work is to report a case of urethral obstruction in a fertile male feline, 2 years old, weighing 5 kg, complaining of probable constipation. During physical examination, the patient presented a lot of pain upon abdominal palpation, which led to sedation for a more detailed examination, revealing a full bladder with apparent stiffness. An anesthetic and therapeutic protocol was implemented to carry out the necessary procedures and monitor the evolution of the case.

Evaluation of etiology, risk factors and clinical signs of feline lower urinary tract disease (FLUTD) in Northern Kerala

Feline lower urinary tract disease (FLUTD) describes multiple ailments and diseases associated with bladder and urethra of cats. A total of 37 cats presented with clinical signs pertaining to lower urinary tract disorders were evaluated in the current study. There were 96.3 per cent males and 3.7 per cent females with maximum distribution in the age group between one to two years (p<0.01). Persian cats (p<0.001) were mostly diagnosed with FLUTD with occurrence of 75.68 per cent. Most of the cats (72.97 per cent) were diagnosed with feline idiopathic cystitis (FIC). The other causes of FLUTD diagnosed were bacterial cystitis (8.12 per cent), bladder rupture/ urine seepage (8.12 per cent), pseudomembranous cystitis (5.4 per cent) and urethral plugs (5.4 per cent). Dry diet and indoor habitat were found to be risk factors (p<0.001) for FLUTD. Clinical signs associated with lower urinary tract like stranguria, pollakiuria and periuria were commonly noticed.

Current State of Non-surgical Devices for Female Stress Urinary Incontinence.

The purpose of this review is to summarize and assess the current non-surgical devices for the treatment of stress urinary incontinence (SUI). Devices for SUI can generally be divided into two categories. One category is the augmentation of pelvic floor muscle training (PFMT), wherein devices such as vaginal cones, intravaginal biofeedback, and electrical or magnetic stimulation are used to strength the pelvic floor musculature, though none are more effective than traditional PFMT. The second category of devices mechanically occludes the outlet and includes incontinence pessaries, intravaginal occlusion devices, and urethral plugs and patches. While these are palliative rather than curative, they share similar rates of improvement in leakage. A number of novel devices exist for the treatment and management of SUI. Though no single device has been shown to be more effective than PFMT alone, they may be beneficial for women who have difficulty isolating their pelvic floor muscles, desire accountability, or prefer technology-based engagement. Outlet occlusion devices are less comfortable for the patient, but remain an option for women who do not desire surgery.

Multicenter retrospective study on the prevalence of idiopathic cystitis in domestic cats within a metropolis

The domestic cat has a predisposition to diseases of the genitourinary system. Among the diseases of the lower urinary tract in a domestic cat, the leading place belongs to cystitis. Among cats living in city apartments, compared with cats on free range, the diagnosis of idiopathic cystitis is 2.5 times more common . The lack of contact of the organism with the environment and threats has led to a decrease in the resistance of cats to stress. Prior to the publication of this article, there was no official information on the age and breed predisposition to idiopathic cystitis in domestic cats within the metropolis of Ukraine. We identified the following groups of pathologies: idiopathic cystitis, urolithiasis, bacterial cystitis and urethral plugs. 2 age groups of animals were formed - up to 6 and older than 6 years. The study involved domestic cats of 29 breeds. The study is retrospective and multicenter and it includes data obtained on the basis of outpatient journals of the network of Zoolux clinics from 09.10.2020 to 12.07.2021. A total of 384 clinical cases were used in the study, of which 44 were eliminated. Idiopathic cystitis was diagnosed in 256 animals (75.3%), of which males - 159 (62.1%) and females - 97 (37.9%). Domestic cats under 6 years of age (179 animals, 69.9%) most often suffered from idiopathic cystitis. Domestic cats of Eastern European breeds were the largest population among patients with idiopathic cystitis of cats of long- and short-haired breeds (138 animals, 53.9%). Key words: dysuria, stranguria, urocystitis, stress factors, urolithiasis, pollakiuria, lower urinary tract.

Rehabilitative care practices in the management of childbirth-related pelvic fistula: A systematic review.

Childbirth-related pelvic fistula (CRF) often requires surgery, yet even with successful repair, mental health conditions, musculoskeletal impairments, urinary and fecal incontinence and sexual dysfunction persist for many women. Postoperative rehabilitation, (i.e., physiotherapy, mental health counseling) may address these concerns and has been reported for this population. This review aims to summarize the literature and level of evidence of rehabilitative care practices in fistula care to inform clinical practice, research and policy recommendations. A systematic literature review was conducted using Africa-Wide Information, CINAHL, Cochrane, Embase, Global Health, PAIS Index, PubMed and SCOPUS searching keywords and MeSH terms to identify women with CRF admitted for surgery. Two researchers progressively screened titles, abstracts and full-text articles. Eligible articles were classified primary if intervention details and outcomes were reported or secondary if rehabilitation was described, but no specific outcomes reported. Relevant study details, strengths and limitations, and key findings were extracted. Eighteen articles were included: eight primary, ten secondary. Primary articles reported on urethral plugs for postoperative urinary incontinence (UI) (2/8), menstrual cup to manage UI (1/8), physiotherapy and health education (3/8) and mental health counseling (2/8). Secondary articles describe rehabilitation components in the context of program descriptions, qualitative analyses or reviews. All evidence was low or very low quality. Research on rehabilitative care is very limited and highlights inconsistencies in practice. This review provides support for the feasibility of rehabilitation and establishes the need for future interventional studies that involve a comparator and reliable outcome measures.

Radiographic diagnoses in 80 cats before and 73 cats after unobstructing the urethra.

The aim of this study was to investigate causes for feline urethral obstruction and determine whether the frequency of radiographic diagnoses differs between cats radiographed before or after unobstruction of the urethra. A retrospective cross-sectional study of cats with naturally occurring urethral obstruction was performed. Only cats presenting for their first urethral obstruction in which radiography was integrated in the initial evaluation were included. The diagnosis frequency (overall and for each disease type) was compared between cats radiographed before or after unobstruction of the urethra. Eighty cats (52%) had radiographs obtained before unobstructing the urethra and 73 cats (48%) had radiographs taken after unobstructing the urethra. Cats radiographed before unobstruction had a greater frequency of radiographic diagnoses than those radiographed after unobstruction (61% versus 45%). This difference was largely due to a greater frequency of urethral plugs detected before unobstruction versus after unobstruction (45% versus 5.5%). Radiographs obtained before unobstructing the urethra provided a diagnostic advantage for detecting a cause for urethral obstruction compared to radiographs obtained after unobstructing the urethra. Urethral plugs were the most common diagnosis.

Fat urological syndrome: incidence, nosological structure

This article describes the results of a study of 128 cats with urological syndrome. The study was conducted to determine the incidence of this syndrome, its nosological structure, analysis of clinical signs, as well as laboratory data characteristic of this syndrome. The data were obtained from the patients of the clinical branches of the DSTU, Rostov-on-Don, the patients had not been treated anywhere before and were first seen with urological syndrome of cats. A medical history was compiled for all cats, a clinical examination was carried out, and blood and urine were collected for analysis. As a result of the studies, it was revealed that as part of the urological syndrome, idiopathic cystitis of cats occurred in 65% of cases, urinary tract infections in 14% of cats, obstruction of the urethra caused by urethral plugs was observed in 68%, urolithiasis in 28%, and only in In 0.7% of cats, proliferative changes in the urethral tract were noted. In 79% of cats with urological syndrome, it was accompanied by urethral obstruction with different mechanisms of occurrence.

Clinicopathological characteristics of cats with signs of feline lower urinary tract disease in the Czech Republic

A total of 214 cats with signs of feline lower urinary tract disease (FLUTD) were assessed in this study. There were 81.30% males (82.20% of them neutered) and 18.70% females (80.00% of them spayed) with an age range from 9 months to 17 years (mean 5.1 ± 3.7). Most of the cats (111; 51.90%) were diagnosed with feline idiopathic cystitis; in 57 (26.60%) cats, uroliths were detected. A urinary tract infection (UTI) as well as urethral plugs were diagnosed in 23 cats (10.75%). In 100 cats, a non-obstructive form of feline lower urinary tract disease (FLUTD) was present; in 114 cats (exclusively males) a urethral obstruction was diagnosed. Most of the cats (141; 65.90%) were indoor-housed. The cats with the UTI were significantly older when compared to the other cases of FLUTD. The most common clinical signs reported by the owners were dysuria (39.70%), oliguria/anuria (31.30%), and vomiting (24.80%). In the cats with the urethral obstruction, oliguria/anuria and non-specific systemic signs were dominant whereas in the non-obstructive form, signs of a lower urinary tract disease were more frequent. The urine specific gravity ranged from 1.008 to 1.080, while in the cats diagnosed with UTI, it was significantly lower than the other cats. Haematuria was the most common finding within the urinalysis which was diagnosed in 181 cats (84.60%): macroscopic haematuria was present in 94 patients (43.90%), microscopic haematuria was present in 87 cats (40.70%). Pyuria was found in 36 cats (16.80%). In the UTI cats, the most common bacterial isolate was E. coli. Results of our study are in agreement with previous reports of FLUTD in various countries, with idiopathic cystitis as the most common cause.

Evaluation of lower urinary tract disease in the Yogyakarta cat population, Indonesia

Background and Aim:This paper reports a retrospective study performed in 185 cats diagnosed with feline lower urinary tract disease (FLUTD). The analyzed population involved feline patients at the Veterinary Clinic of Universitas Gadjah Mada, Indonesia. This research aimed to evaluate the clinical indications and causes of FLUTD in the Yogyakarta cat population.Materials and Methods:The medical data of all feline patients were obtained to conduct this study. FLUTD diagnoses were based on physical examinations, urinalyses, ultrasound examinations, and bacterial cultures. Only cats with a complete examination were used in the study. The clinical signs were evaluated and accompanied by the results of laboratory tests in cats that showed symptoms of FLUTD. The medical history of all feline patients was analyzed thoroughly. Most of the feline’s urine samples were collected by catheterization.Results:The most commonly diagnosed of FLUTD in the Yogyakarta cat population were: feline idiopathic cystitis (FIC) (56%), urinary tract infection (UTI; 25%), urolithiasis (13%), urethral plugs (UP) (4.9%), and neoplasia (0.4%), respectively. The prevalence of UTI is higher than that reported in Europe or the US. Older cats more often show symptoms of UTI and neoplasia, whereas young cats more often show symptoms of FIC and UP. The prevalence of male cats experiencing FLUTD in Yogyakarta is much higher than female cats.Conclusion:The incidence rate of FLUTD cases in Yogyakarta is related to age and sex. The results of this study are similar to those of the previous research studies conducted in other countries.

Causes of lower urinary tract disease in Czech cat population

This study was done to investigate epidemiological data and to report causes of lower urinary tract disease in a population of cats presented at the Small Animal Clinic of the University of Veterinary and Pharmaceutical Sciences Brno. Cats presented with lower urinary tract disease signs that had undergone a thorough physical examination and urinalysis (dipstick, urine specific gravity, urine sediment and dipslide urine culture) were included in the study. Urine samples were collected only by cystocentesis or sterile catheterization. Bloodwork, abdominal ultrasound, and abdominal radiographs were performed in 118 (66%), 170 (96%) and 9 (5%) patients, respectively. Cats that were treated with antibiotics or glucocorticoids during an episode of feline lower urinary tract disease (FLUTD) or during the foregoing month and which had undergone perineal urethrostomy or catheterization in private practice, were excluded. The study population consisted of 177 cats. Forty-one (23%) cats were diagnosed with a urethral plug, 26 cats (14%) with a urinary tract infection (UTI), 9 cats (5%) with urolithiasis and 101 cats (57%) with feline idiopathic cystitis (FIC). The cats diagnosed with UTI were significantly older than the cats with FIC, urethral plugs and urolithiasis. Urinary tract infection was diagnosed significantly more often in patients older than 10 years, and in female cats. The diagnosis of urethral plug was made significantly more often in males. Feline idiopathic cystitis and urethral plugs are the most common causes of FLUTD, and the causes are significantly age and sex-related.

Urethral obstruction in male cats in some Northern United States shows regional seasonality

Feline lower urinary tract disease (FLUTD) is a term encompassing several different conditions affecting the feline lower urinary tract. Certain FLUTD aetiologies, such as idiopathic cystitis, urethral plugs or urolithiasis, commonly produce urethral obstruction (UO) in male cats. It is widely accepted that environmental, behavioural and dietary factors can play a role in the aetiopathogenesis of these conditions. We investigated the seasonal prevalence of UO by analysing admission dates of 2443 male cats with UO from eight practices in the Northern USA over a 4-year period. A significantly greater number of cats presented for UO in April and May (P < 0.025). When stratified by geographic location, a spring peak was found in cats from the North-Eastern United States, but no peak was demonstrable in cats from the North-West coast. This suggests that UO might depend, at least in part, on geographical climatic variations.

Injectable Anesthesia for Mice: Combined Effects of Dexmedetomidine, Tiletamine-Zolazepam, and Butorphanol.

Anesthetic protocols for murine models are varied within the literature and medetomidine has been implicated in the development of urethral plugs in male mice. Our objective was to evaluate the combination of butorphanol, dexmedetomidine, and tiletamine-zolazepam. A secondary objective was to identify which class of agent was associated with urethral obstructions in male mice. BALB/c male (n = 13) and female (n = 23) mice were assigned to dexmedetomidine and tiletamine-zolazepam with or without butorphanol or to single agent dexmedetomidine or tiletamine-zolazepam. Anesthesia was achieved in 58% (14/24) of mice without butorphanol and in 100% (24/24) of mice with butorphanol. The combination of dexmedetomidine (0.2 mg/kg), tiletamine-zolazepam (40 mg/kg), and butorphanol (3 mg/kg) resulted in an induction and anesthetic duration of 12 and 143 minutes, respectively. Urethral obstructions occurred in 66% (25/38) of trials in male mice that received dexmedetomidine with a mortality rate of 38% (5/13). Tiletamine-zolazepam, when used alone, resulted in a 0% (0/21) incidence of urethral obstructions. Combination use of dexmedetomidine, tiletamine-zolazepam, and butorphanol results in a longer and more reliable duration of anesthesia than the use of dexmedetomidine and tiletamine-zolazepam alone. Dexmedetomidine is not recommended for use in nonterminal procedures in male mice due to the high incidence of urethral obstructions and resultant high mortality rate.

Surgical Management of Urethral Plugs in a Male Shih-Tzu Dog

A 6-year-old castrated male Shih-Tzu was admitted to the Gyeongsang Animal Medical Center with hematuria and vomiting. Serum chemistry indicated increases in blood urea nitrogen and creatinine values. Radiography showed radiopaque materials attached to the ventralis of the inner bladder wall. Penile urethra also was filled with radiopaque materials. Ultrasonography revealed bilateral perineal effusion in the kidney, thinned bladder wall, and materials with acoustic shadowing at the caudal extremity of the os penis. Because urination was not identified by urinary obstruction, cystocentesis was performed. Hematuria was diagnosed by urinalysis, but clear crystals were not identified. Owing to failure of securing patency to the bladder using retrohydropropulsion, cystotomy and urethrotomy with retrohydropropulsion were performed. In this report, we describe the clinical and radiographic findings of urethral plugs in a male Shih-Tzu dog, wherein the urethral plugs were treated successfully with hydropropulsion, cystotomy, and urethrotomy. It provides an option for the treatment of urethral plugs in a dog.

Urethral Plugs in Dogs

BackgroundCrystalline‐matrix urethral plugs have not been previously reported in dogs.Hypothesis/ObjectivesTo report the composition of urethral plugs in dogs, describe clinical features of the disease, and identify overrepresented breeds.MethodsRetrospective case series. A Minnesota Urolith Center (MUC) record search was performed for urethral plugs in dogs submitted during a 6‐year period. The composition of the plugs and signalment of affected dogs were recorded. Breed risk analysis was performed using a control group without plugs from the Veterinary Medical Center, University of Minnesota (VMC UMN). Breed risk was also calculated for a group of dogs with struvite (plugs and uroliths). Medical records for the subset of plug cases from the VMC UMN were reviewed and described.ResultsBetween 2006 and 2011, 42 urethral plugs from dogs were submitted to the MUC. All came from male dogs, and the mineral component of the majority (83%) was struvite. Thirty (71%) samples were from Pugs. Pugs were overrepresented in plug submissions (OR 179; CI 88–389; P < .001), and for struvite in general (OR 14.3; CI 7.9–24.4; P < .001). Nine of the dogs were treated at VMC UMN; all were castrated male Pugs. None of these cases had bacteriuria or positive urine cultures, and no underlying cause of plug formation was identified.Conclusions and Clinical ImportanceWhen evaluating dogs with urethral obstruction, plugs need to be considered, especially in male Pugs. Further investigation into the underlying cause of plug formation in dogs is warranted.

Feline lower urinary tract disease in a German cat population

To investigate epidemiologic data, clinical signs, results of urinalysis and causes of lower urinary tract disease in a German veterinary hospital population of cats and to determine if the demographic data, history, clinical signs and urinalysis results correlate with a particular etiology. Cats presented with signs of feline lower urinary tract disease (FLUTD) with a documented history and physical examination, a complete urinalysis (urine specific gravity, urine dipstick and sediment, urine culture) of urine obtained by cystocentesis or catheterization, and diagnostic imaging of the urinary tract were included into the study. Cats that had received a previous treatment during the same episode of FLUTD were excluded. A total of 302 cats were included into the study. Cats with FLUTD presented throughout the seasons with similar frequency. The most common diagnosis was feline idiopathic cystitis (FIC) (55.0%), followed by bacterial urinary tract infection (UTI) (18.9%), urethral plug (10.3%) and urolithiasis (7.0%). Urethral obstruction was significantly more frequent in cats with FIC than in cats with UTI. Cats with FIC and urethral plugs were significantly younger and had significantly higher body weights than cats with UTI and neoplasia. FIC and urethral plugs were significantly more common causes of FLUTD in cats younger than 10 years compared to cats that were 10 years or older (65.2% versus [vs.] 35.8% and 13.3% vs. 3.0%), while the incidences of UTI and neoplasia increased with age (12.9% vs. 41.8% and 1.0% vs. 13.4%). FIC and UTI are the most common diagnoses in cats with FLUTD, with a significant age-related difference in incidence.

Evaluation of urinalyses from untreated adult cats with lower urinary tract disease and healthy control cats: predictive abilities and clinical relevance.

This case-controlled study evaluated urinalyses from 111 primary cases diagnosed with feline lower urinary tract disease (FLUTD) and 101 healthy control cats. Urine samples were analysed by standardised procedures, and differences between the two groups were compared by multivariable logistic regression analysis, while controlling for age, body weight, gender and reproductive status. Further, the ability of using urine sediment findings to predict bacteriuria was evaluated. In addition, urinalyses from cats with bacterial cystitis, idiopathic cystitis, urolithiasis and urethral plugs were compared. The main findings were that increasing body weight was significantly associated with increased odds of FLUTD, while the influence of age and reproductive status was of less importance. Increasing amounts of red blood cells and epithelial cells were significantly associated with increased odds of FLUTD. The predictive ability of using bacterial sediment findings to predict bacterial growth was dependent on subjective grading of the amount of bacteria in the sediment and was, at best, only moderate. The few significant differences found between the different FLUTD diagnoses were of limited diagnostic value.

Obstetric fistula: the use of urethral plugs for the management of persistent urinary incontinence following successful repair

The objectives of this study are to analyse the effect of a urethral plug as a means of controlling persistent urinary incontinence following successful repair of an obstetric vesicovaginal fistula (VVF) and to identify factors which might influence potential success or failure. Data from Physiotherapy Department records of a series of 181 women referred for urethral plug assessment following successful repair of VVF were studied retrospectively. Outcome in terms of continence status with the plug was considered in relation to estimated bladder size, urethral length and diameter, and vaginal scarring. A total of 137 women (75.7 %) reported being dry whilst using a urethral plug and 18 (9.9 %) half dry. There were 26 women (14.4 %) who remained wet, 17 of whom had a new or wide urethra. A total of 101 women (55.8 %) had a smaller than normal estimated bladder size (linear measurement from urethral meatus to the deepest point of the bladder = <7.5 cm) and were more likely to remain wet although this was not found to be statistically significant. Adverse incidents included rupture of the urethral plug (two) and migration of a plug into the bladder, requiring cystoscopic removal (six) A urethral plug appears to be an effective means of restoring or improving continence in women with persistent urinary incontinence following successful repair of obstetric VVF although data on long-term outcome were not available for analysis. Success rates may be lower if women have a significantly reduced bladder capacity or a new or wide urethra.

Effect of intraurethral administration of atracurium besylate in male cats with urethral plugs

To evaluate the effect of intraurethral administration of atracurium besylate for urinary obstruction resulting from urethral plugs in male cats. Forty-five male cats were divided into the treatment group (n=25), in which 4 mL atracurium besylate solution (0·5 mg/mL) was injected into the urethral lumen, and the control group (n=20), treated with saline. All cats were then submitted to retrograde flushing until the removal of the occlusion was obtained. The percentage of cats in which the plug was removed at the first attempt was significantly (P<0·05) higher in the treatment group (64%) than in the control group (15%). Moreover, the mean (±SD) time required for the removal of the urethral obstruction was significantly shorter in the treatment group than in the control group (21·1 ±16·2 seconds versus 235·2 ±132·4 seconds; P<0·001). The results of this study indicate that in adult male cats with urethral plugs, urethral administration of atracurium besylate increases the proportion of animals in which the obstruction is removed at the first attempt and reduces the time required to remove the urethral plugs.