Article

Acquired urinary incontinence in the bitch Update and perspectives from human medicine Part 2 The urethral component, pathophysiology and medical treatment

Department of Companion Animal Clinical Sciences B44, College of Veterinary Medicine, University of Liège, 4000 Liège, Belgium.
The Veterinary Journal (Impact Factor: 2.17). 10/2010; 186(1):18-24. DOI: 10.1016/j.tvjl.2010.06.011
Source: PubMed

ABSTRACT Various pathologies can affect the bladder and/or urethral contractility causing signs of urinary incontinence. In this second part of a three-part review, the pathophysiology of impaired urethral contractility (including urethral hyper- and hypotonicity) in the bitch and in women is discussed. Urethral sphincter mechanism incompetence (USMI) is the most common form of acquired urinary incontinence in bitches and is characterized by a decreased urethral tone. The pathophysiology and current recommended medical treatment options for USMI and cases of modified urethral tonicity due to a neurological disorder or functional outlet obstruction are discussed. Treatment options in human medicine in cases of impaired urethral contractility are described.

Download full-text

Full-text

Available from: Stéphanie Noël, Jun 20, 2015
5 Followers
 · 
307 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Urethral sphincter mechanism incompetence (USMI) is the most common cause of urinary incontinence 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.
    The Veterinary Journal 11/2009; 186(1):25-31. DOI:10.1016/j.tvjl.2009.10.002 · 2.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The normal sonographic thickness of the individual layers (ie mucosa, submucosa, muscularis and subserosa-serosa) of the intestinal wall was evaluated in 20 clinically healthy cats. The mean thickness of the wall was 2.20 mm, 2.22 mm, 3.00 mm and 2.04 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively. The mean thickness of the mucosal layer was 1.27, 1.2, 0.46 and 0.49 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, and its contribution to wall thickness was significantly greater than that of the other layers in the duodenum (57.7%) and jejunum (55.2%). The mean thickness of submucosal layer was 0.36, 0.36, 1.49 and 0.53 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, and its contribution to wall thickness was greater than that of the muscularis in the duodenum (16.3%), jejunum (16%) and ileum (fold) (49.8 %). The mean thickness of muscularis was 0.28, 0.35, 0.66 and 0.65 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, with a corresponding contribution to wall thickness of 12.7 %, 14.4%, 22% and 31.6%. Finally, the mean thickness of serosa was 0.29, 0.31, 0.38 and 0.38 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, with a corresponding contribution to wall thickness of 13.3%, 14.4%, 12.7 % and 18.7%. These values can provide baseline information that might be useful in evaluating intestinal disorders affecting preferentially some of the intestinal layers.
    10/2013; 16(4). DOI:10.1177/1098612X13509080
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: An increased risk of urinary incontinence in bitches has often been associated with previous ovariohysterectomy but remains controversial. The objective of this study was to evaluate the strength of evidence for an association between neutering or age at neutering and urinary incontinence in bitches and to estimate the magnitude of any effect found. A systematic review of peer-reviewed original English analytic journal articles was conducted, based on Cochrane guidelines (Higgins and Green 2009) Of 1,853 records screened, seven studies were identified that examined the effect of neutering or age at neutering on the risk of urinary incontinence but four were judged to be at high risk of bias. Of the remaining three studies, which were at moderate risk of bias, there was some weak evidence that neutering, particularly before the age of three months, increases the risk of urinary incontinence. However, overall the evidence is not consistent nor strong enough to make firm recommendations on the effect of neutering or age at neutering on the risk of urinary incontinence.
    Journal of Small Animal Practice 02/2012; 53(4):198-204. DOI:10.1111/j.1748-5827.2011.01176.x · 0.91 Impact Factor