Placement of an artificial urethral sphincter in 8 male dogs with urethral diverticulum

• Published in: Journal of veterinary internal medicine 2024-07, Vol.38 (4), p.2171-2179
• Main Authors: Neumann, Geoffrey, Vachon, Catherine, Culp, William T.N., Palm, Carrie, Byron, Julie K., Pogue, Joanna, Dunn, Marilyn
• Format: Article
• Language: English
• Subjects: Animals; Bladder; canine; Diverticulum - surgery; Diverticulum - veterinary; Dog Diseases - surgery; Dogs; Fistula; incontinence; Male; occluder; Prostate; Retrospective Studies; SMALL ANIMAL; Surgeons; Ultrasonic imaging; Urethral Diseases - surgery; Urethral Diseases - veterinary; Urinary incontinence; Urinary Incontinence - surgery; Urinary Incontinence - veterinary; Urinary Sphincter, Artificial - veterinary; urinary tract; Urine; Veterinary medicine
• ISSN: 0891-6640; 1939-1676; 1939-1676
• DOI: 10.1111/jvim.17102

Background Urethral diverticulum (UD) is a poorly defined anomaly consisting of an outpouching of the urethra. Management without surgical resection is not previously reported in dogs. Hypothesis/Objectives Report the outcome of male dogs presented for urinary incontinence with UD treated with an artificial urethral sphincter (AUS). Animals Eight client‐owned dogs with UD treated with an AUS. Methods Multicenter retrospective study. Medical records from male dogs with urinary incontinence were reviewed. Inclusion criteria:  diagnosis of a UD by retrograde cystourethrography, cystoscopy, abdominal ultrasonography or contrast computed tomodensitometry (CT) or a combination of these modalities, AUS placement, and at least 1 follow‐up. Urinary continence score (UCS) was attributed retrospectively. Results Median UCS at presentation was 1/5. A contrast cystourethrogram was diagnostic in 8/8 dogs. All diverticula were saccular, and 7/8 were within the prostatic urethra and 1/8 extended up to the membranous urethra. A congenital origin was suspected in 7 dogs and acquired in 1. Concurrent anomalies included renal dysplasia or chronic pyelonephritis (n = 4), bilateral cryptorchidism (n = 3), and pelvic urinary bladder (n = 3). All dogs were poorly/moderately responsive to phenylpropanolamine. Artificial urethral sphincter placement resulted in improvement in continence in all dogs with a median UCS of 4/5 (5/5 in 2/8 dogs, 4/5 in 5/8 dogs, 3/5 in 1/8 dogs). Conclusion Urethral diverticulum should be considered in male dogs with persistent urinary incontinence not responding to medical management. Artificial urethral sphincter placement is an effective therapeutic option that improved continence scores in all dogs.