Cystourethropexy to Correct Refractory Urinary Incontinence Due to Urethral Sphincter Mechanism Incompetence Preliminary Results in Ten Bitches

Authors

  • BRUNO J. MASSAT Dr Med Vet,

    1. Veterinary Medical Teaching Hospital
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  • CLARE R. GREGORY DVM, Dipiomate ACVS,

    1. Departments of Surgery, School of Medicine, University of California, Davis, California. Presented at the ACVS Veterinary Symposium, San Francisco, California
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  • GERALD V. LING dvm,

    1. Departments of Medicine, School of Medicine, University of California, Davis, California. Presented at the ACVS Veterinary Symposium, San Francisco, California
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  • GEORGE H. CARDINET dvm, PhD,

    1. Departments of Anatomy, School of Veterinary Medicine, School of Medicine, University of California, Davis, California. Presented at the ACVS Veterinary Symposium, San Francisco, California
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  • ERNEST L. LEWIS md

    1. Department of Urology, School of Medicine, University of California, Davis, California. Presented at the ACVS Veterinary Symposium, San Francisco, California
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Abstract

Cystourethropexy was performed in 10 bitches with refractory urinary incontinence due to urethral sphincter mechanism incompetence. All animals had an abnormally shaped vesico-urethral junction. The bladder neck was located in the pelvic canal in nine dogs (pelvic bladder). Surgery alone restored urinary continence in two cases and markedly improved incontinence in two cases. Surgery combined with medical therapy (phenylpropanolamine, 1.5 mg/kg orally once or twice a day, using a sustained-action preparation) restored urinary continence in four cases and markedly improved continence in one case. Surgery, with medical therapy, was completely ineffective in one case. No major complications were encountered in any dogs. In four cases, histopathologic evaluation of the dorsal bladder wall and neck revealed the presence of a single, perinuclear, clear vacuole in the cytoplasm of smooth muscle fibers. Electron microscopic examination showed that the vacuoles represented a dilatation of normal membrane organelles. Such abnormalities have the potential to alter the smooth muscle motility. This study indicates that cystourethropexy alone restored urinary continence only temporarily in the majority of the patients. The significance and frequency of the histopathologic findings requires further investigation.

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