Long-Term Efficacy of a Percutaneously Adjustable Hydraulic Urethral Sphincter for Treatment of Urinary Incontinence in Four Dogs

• Published in: Veterinary surgery Vol. 38; no. 6; pp. 747 - 753
• Main Authors: ROSE, SCOTT A., ADIN, CHRISTOPHER A., ELLISON, GARY W., SEREDA, COLIN W., ARCHER, LINDA L.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.08.2009; Blackwell Publishing Ltd
• Subjects: Animals; Clinical outcomes; Dog Diseases - surgery; Dogs; Female; Pilot Projects; Prostheses and Implants - veterinary; Surgical techniques; Transplants & implants; Urethra - surgery; Urinary incontinence; Urinary Incontinence - surgery; Urinary Incontinence - veterinary; Veterinary medicine
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/j.1532-950X.2009.00560.x

Objective— To evaluate the efficacy of a surgically placed, static hydraulic urethral sphincter (SHUS) for treatment of urethral sphincter mechanism incompetency (USMI). Study Design— Prospective study. Animals— Spayed female dogs (n=4) with acquired USMI. Methods— Urinary incontinence was assessed using a subjective continence score before and after implantation of an SHUS on the proximal urethra via ventral median celiotomy. Dogs were assessed for urinary continence, urinary tract infections, and implant‐associated complications for 30 months. Residual incontinence was treated with percutaneous inflation of the SHUS with sterile saline solution through a biocompatible subcutaneous administration port. Results— At last follow‐up (26–30 months after surgery), continence scores improved from a median preoperative score of 3/10 to a median postoperative score of 10. One dog developed wound drainage over the subcutaneously placed administration port but remained continent after port removal. Three occluders were percutaneously filled with additional saline (median, 0.18 mL; mean, 0.16 mL) to improve continence after surgery. Conclusions— Application and adjustment of an SHUS provided sustained improvements in continence score in all dogs. Clinical Relevance— In this pilot study, 3 of 4 dogs with hydraulic urethral sphincter implantation had successful percutaneous adjustment and maintained improved continence scores for 2 years after surgery. Continence was maintained in the 4th dog even after administration port removal. Based on this pilot study, the SHUS warrants further clinical evaluation for treatment of dogs with USMI unresponsive to medical management.