title: Use of a percutaneously controlled urethral hydraulic occluder for treatment of refractory urinary incontinence in 18 female dogs.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of a percutaneously controlled urethral hydraulic occluder (HO) device for the treatment of refractory urinary incontinence (RUI) in female dogs with various urogenital anomalies.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Female dogs with RUI (n = 18).
  
  
  METHODS
  Retrospective evaluation of dogs after a silicone ring (HO) was surgically placed around the proximal urethra. The ring was connected to a subcutaneous injection port with actuating tubing. Residual incontinence was treated with percutaneous infusion of sterile saline into the device to provide extraluminal urethral compression. Dogs were assessed for continence (owner-assessed 10-point continence scale) and complications at standard time points.
  
  
  RESULTS
  All 18 dogs had significantly improved continence scores (P < .001) after HO placement (median and mean score pre-HO = 2.8 and 3.3; post-HO = 10 and 8.9, respectively) with a median follow-up time of 32 months. "Functional" continence (score ≥ 9) was achieved in 67% of dogs after HO placement, though only 13/18 clients were compliant with inflations. Of dogs belonging to compliant owners, 12 (92%) had a functional continence score. Six dogs (33%) did not require inflation to achieve continence. Urethral obstruction occurred as a complication in 3 dogs.
  
  
  CONCLUSIONS
  Use of an HO device was an effective long-term treatment for RUI when traditional options failed. The technique was associated with some complications, and these risks should be considered before use.
authors.affiliation: Department of Surgery, Bobst Hospital of The Animal Medical Center, New York, NY 10065, USA.
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Currao
authors.forename: Allyson C
authors.initials: AC
authors.lastname: Berent
authors.forename: Chick
authors.initials: C
authors.lastname: Weisse
authors.forename: Philip
authors.initials: P
authors.lastname: Fox
mesh_terms: D000818:Animals; D004285:Dogs; D005260:Female; D055595:Mechanical Phenomena; D011474:Prosthesis Design; D012189:Retrospective Studies; D014521:Urethra / Q000601:surgery*; D014549:Urinary Incontinence / Q000601:surgery / Q000662:veterinary*; D016741:Urinary Sphincter, Artificial / Q000662:veterinary*