[en] Urethral sphincter mechanism incompetence (USMI) is the most common cause of urinary inence in dogs. Surgery may be recommended if the animal does not respond to medical treatment or becomes refractory. In this third part of a three-part review, surgical options for the treatment of USMI are described. Colposuspension is the most frequently described procedure and offers a fair prognosis, with about 50% of the dogs being continent after surgery and most of the reminder being improved or more responsive to medical treatment. Urethropexy offers a similar success rate, but with a higher rate of complications.
Endoscopic injection of collagen is an attractive technique due to its minimally invasive nature
and low risk of adverse effects. Initial results may however deteriorate with time. Other procedures have been reported, but involve a low number of cases and have resulted in variable success rates. In women, stress urinary incontinence is mainly treated by minimally invasive procedures involving vaginal placement of sub-urethral slings.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Claeys, Stéphanie ; Université de Liège - ULiège > Département clinique des animaux de compagnie et des équidés > Chirurgie des animaux de compagnie
Noël, Stéphanie ; Université de Liège - ULiège > Département clinique des animaux de compagnie et des équidés > Chirurgie et clinique chirurgicale des petits animaux
Hamaide, Annick ; Université de Liège - ULiège > Département clinique des animaux de compagnie et des équidés > Chirurgie des animaux de compagnie
Language :
English
Title :
Acquired urinary incontinence in the bitch: Update and perspectives from human medicine. Part 3: The urethral component and surgical treatment.
Adin C.A., Farese J.P., Cross A.R., Provitola M.K., Davidson J.S., Jankunas H. Urodynamic effects of a percutaneously controlled static hydraulic urethral sphincter in canine cadavers. American Journal of Veterinary Research 2004, 65:283-288.
Alcalay M., Monga A., Stanton S.L. Burch colposuspension: a 10-20 year follow-up. British Journal of Obstetrics and Gynaecology 1995, 102:740-745.
Angioletti A., De Francesco I., Vergottini M., Battocchio M.L. Urinary incontinence after spaying in the bitch: incidence and oestrogen-therapy. Veterinary Research Communications 2004, 28:153-155.
Arnold S., Arnold P., Hubler M., Casal M., Rusch P. Incontinentia urinae bei der Kastrierten Hundin: Haufigkeit und Rassedisposition. Schweisar Archiv fur Tierheilkunde 1989, 131:259-263.
Arnold S., Jager P., DiBartola S.P., Lott-Stolz G., Hauser B., Hubler M., Casal M., Fairburn A., Rusch P. Treatment of urinary incontinence in dogs by endoscopic injection of Teflon. Journal of the American Veterinary Medical Association 1989, 195:1369-1374.
Arnold S., Hubler M., Lott-Stolz G., Rusch P. Treatment of urinary incontinence in bitches by endoscopic injection of glutaraldehyde cross-linked collagen. Journal of Small Animal Practice 1996, 37:163-168.
Barth A., Reichler I.M., Hubler M., Hassig M., Arnold S. Evaluation of long-term effects of endoscopic injection of collagen into the urethral submucosa for treatment of urethral sphincter incompetence in female dogs: 40 cases (1993-2000). Journal of the American Veterinary Medical Association 2005, 226:73-76.
Berent, A., Weisse, C., Adan, C., Todd, K., 2009. The use of a percutaneously controlled hydraulic occluder for the treatment of urethral sphincter mechanism incompetence in 11 dogs and 1 cat. In: Proceedings of the ACVIM Forum, Montréal, Canada, p. 686.
Burch J.C. Urethrovaginal fixation to Cooper's ligament for correction of stress incontinence, cystocele, and prolapse. American Journal of Obstetrics and Gynecology 1961, 81:281-290.
Burch J.C. Cooper's ligament urethrovesical suspension for stress incontinence. Nine years' experience - results, complications, technique. American Journal of Obstetrics and Gynecology 1968, 100:764-774.
Bushby P.A., Hankes G.H. Sling urethroplasty for the correction of urethral dilation and urinary incontinence. Journal of the American Animal Hospital Association 1980, 16:115-118.
Daneshgari F., Moore C. Advancing the understanding of pathophysiological rationale for the treatment of stress urinary incontinence in women: the 'trampoline theory'. British Journal of Urology International 2006, 98:8-14.
de Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. European Urology 2003, 44:724-730.
de Leval J., Waltregny D. New surgical technique for treatment of stress urinary incontinence TVT-Obturator: new developments and results. Surgical Technology International 2005, 14:212-221.
Dean P.W., Novotny M.J., O'Brien D.P. Prosthetic sphincter for urinary incontinence: results in three cases. Journal of the American Animal Hospital Association 1989, 25:447-454.
DeLancey J.O. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. American Journal of Obstetrics and Gynecology 1994, 170:1713-1720.
Delorme E. La bandelette trans-obturatrice. un procédé mini-invasif pour traiter l'incontinence urinaire d'effort de la femme. Progres En Urologie 2001, 11:1306-1313.
Delorme E., Droupy S., de Tayrac R., Delmas V. Transobturator tape (Uratape): a new minimally-invasive procedure to treat female urinary incontinence. European Urology 2004, 45:203-207.
Enhörning G. Simultaneous recording of intravesical and intra-urethral pressure: a study of urethral closure in normal and stress incontinent women. Acta Chirurgica Scandinavica 1961, 276:1-68.
Fantl J.A., Hurt W.G., Bump R.C., Dunn L.J., Choi S.C. Urethral axis and sphincteric function. American Journal of Obstetrics and Gynecology 1986, 155:554-558.
Fossum T.W. Small Animal Surgery 2002, Elsevier, p. 603. second ed.
Gregory S.P., Holt P.E. Effect of body position on intravesical pressure in the anaesthetised bitch. Veterinary Record 1992, 130:288-290.
Hermieu J.F. Bandelettes sous-urétrales dans l'incontinence urinaire d'effort de la femme: revue des différents procédés. Annales d'Urologie 2005, 39:124-136.
Holt P.E. Urinary incontinence in the bitch due to sphincter mechanism incompetence: prevalence in referred dogs and retrospective analysis of sixty cases. Journal of Small Animal Practice 1985, 26:181-190.
Holt P.E. Urinary incontinence in the bitch due to sphincter mechanism incompetence: surgical treatment. Journal of Small Animal Practice 1985, 26:237-246.
Holt P.E. Urinary incontinence in dogs and cats. Veterinary Record 1990, 127:347-350.
Holt P.E. Long-term evaluation of colposuspension in the treatment of urinary incontinence due to incompetence of the urethral sphincter mechanism in the bitch. Veterinary Record 1990, 127:537-542.
Holt P.E., Gregory S.P. Can urethral pressure profilometry predict the response to colposuspension in bitches?. Veterinary Record 1991, 128:281-282.
Krawiec D.R. Diagnosis and treatment of acquired canine urinary incontinence. Companion Animal Practice 1989, 19:12-20.
Marchevsky A.M., Edwards G.A., Lavelle R.B., Robertson I.D. Colposuspension in 60 bitches with incompetence of the urethral sphincter mechanism. Australian Veterinary Practitioner 1999, 29:2-8.
Massat B.J., Gregory C.R., Ling G.V., Cardinet G.H., Lewis E.L. Cystourethropexy to correct refractory urinary incontinence due to urethral sphincter mechanism incompetence. Preliminary results in ten bitches. Veterinary Surgery 1993, 22:260-268.
Muir P., Goldsmid S.E., Bellenger C.R. Management of urinary incontinence in five bitches with incompetence of the urethral sphincter mechanism by colposuspension and a modified sling urethroplasty. Veterinary Record 1994, 134:38-41.
Nickel R.F., Wiegand U., Van Den Brom W.E. Evaluation of a transpelvic sling procedure with and without colposuspension for treatment of female dogs with refractory urethral sphincter mechanism incompetence. Veterinary Surgery 1998, 27:94-104.
Nilsson C.G., Kuuva N., Falconer C., Rezapour M., Ulmsten U. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. International Urogynecology Journal and Pelvic Floor Dysfunction 2001, 12:S5-S8.
Noël S., Claeys S., Hamaide A. Acquired urinary incontinence in the bitch: update and perspectives from human medicine. Part 1: the bladder component, pathophysiology and medical treatment. The Veterinary Journal 2009, 186:10-17.
Noël, S., Claeys, S., Hamaide, A., 2009b. Acquired urinary incontinence in the bitch: update and perspectives from human medicine. Part 2: the urethral component, pathophysiology and medical treatment. The Veterinary Journal. submitted for publication.
Rawlings C., Barsanti J.A., Mahaffey M.B., Bement S. Evaluation of colposuspension for treatment of incontinence in spayed female dogs. Journal of the American Veterinary Medical Association 2001, 219:770-775.
Sanjurjo S., Ben Younes A., Bonnet P., Andrianne R., de Leval J. Le TVT: traitement révolutionnaire de l'incontinence urinaire. Revue Médicale de Liège 2002, 57:765-770.
Sergent F., Sebban A., Verspyck E., Senthiles L., Lemoine J.P., Marpeau L. Complications per et post-opératoires du TVT (Tension-free Vaginal Tape). Progrès En Urologie 2003, 13:648-655.
Ulmsten U., Henriksson L., Johnson P., Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. International Urogynecology Journal and Pelvic Floor Dysfunction 1996, 7:81-86.
Ulmsten U. Some reflections and hypotheses on the pathophysiology of female urinary incontinence. Acta Obstetricia et Gynecologica Scandinavica. Supplement 1997, 166:3-8.
Waltregny D., Reul O., Mathantu B., Gaspar Y., Bonnet P., de Leval J. Inside out transobturator vaginal tape for the treatment of female stress urinary incontinence: interim results of a prospective study after a 1-year minimum follow up. Journal of Urology 2006, 175:2191-2195.
Waltregny D., de Leval J. The TVT-obturator surgical procedure for the treatment of female stress urinary incontinence: a clinical update. International Urogynecology Journal and Pelvic Floor Dysfunction 2009, 20:337-348.
Waltregny D., Gaspar Y., Reul O., Hamida W., Bonnet P., de Leval J. TVT-O for the treatment of female stress urinary incontinence. Results of a prospective study after a 3-year minimum follow-up. European Urology 2008, 53:401-410.
White R.N. Urethropexy for the management of urethral sphincter mechanism incompetence in the bitch. Journal of Small Animal Practice 2001, 42:481-486.
Wood J.D., Simmons-Byrd A., Spievack A.R., Badylak S.F. Use of a particulate extracellular matrix bioscaffold for treatment of acquired urinary incontinence in dogs. Journal of the American Veterinary Medical Association 2005, 226:1095-1097.
