Use of a percutaneously controlled urethral hydraulic occluder for treatment of refractory urinary incontinence in 18 female dogs.

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. STUDY
DESIGN: Case series. ANIMALS: 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. © Copyright 2013 by The American College of Veterinary Surgeons.