title: Use of a percutaneously controlled hydraulic occluder for treatment of refractory urinary incontinence in three female cats.
abstract: CASE DESCRIPTION 3 cats were referred for evaluation of chronic urinary incontinence. CLINICAL FINDINGS A presumptive diagnosis of urethral sphincter mechanism incompetence (USMI) was made in all 3 cats. Preoperatively, incontinence was mild in 1 cat (incontinence during sleep) and moderate to severe (incontinence while awake and at rest) in 2. Structural abnormalities noted during cystoscopy included urethrovestibular junction stenosis (n = 1), vaginal stenosis (1), short urethra (1), and intrapelvic bladder (1). TREATMENT AND OUTCOME All 3 cats were treated by means of implantation of an inflatable silicone hydraulic occluder (HO) via a ventral midline celiotomy. Immediately prior to HO implantation, patients underwent cystoscopy to detect any anatomic abnormalities and confirm the absence of ureteral ectopia. Following surgery, all 3 patients attained complete continence, needing 0 or 1 inflation of the device. Complications included cystoscopy-associated urethral tear (n = 1), constipation (1), stranguria (1), hematuria (2), and urinary tract infection (2). Device explantation was performed 14 weeks after surgery in 1 cat because of postoperative constipation. Constipation persisted and urinary incontinence recurred but was markedly improved following device removal in this cat (leakage of urine only when sleeping at follow-up 29 months after surgery [26 months after device explantation]). At the time of last follow-up, 2 of the 3 cats remained fully continent approximately 3 and 6 years after device implantation. CLINICAL RELEVANCE Findings suggested that implantation of an HO may be a safe and effective long-term treatment for some cats with USMI. Further studies are necessary to evaluate the potential for treatment-related complications and the long-term outcome.
authors.forename: Kendall E
authors.initials: KE
authors.lastname: Wilson
authors.forename: Allyson C
authors.initials: AC
authors.lastname: Berent
authors.forename: Chick W
authors.initials: CW
authors.lastname: Weisse
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000628:therapy*; D002415:Cats; D005260:Female; D005500:Follow-Up Studies; D019736:Prostheses and Implants / Q000662:veterinary*; D012828:Silicones; D014549:Urinary Incontinence / Q000628:therapy / Q000662:veterinary*
chemical_list: D012828:Silicones