Laparoscopic placement and urodynamic effects of an artificial urethral sphincter in cadaveric dogs

Objective To describe a laparoscopic approach for placement of a percutaneously controlled artificial urethral sphincter (AUS) in female cadaver dogs and compare the change in urethral pressure and lumen diameter after filling the device. Study Design Experimental study. Animals Canine female cadave...

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Bibliographic Details
Published in:Veterinary surgery 2016-11, Vol.45 (S1), p.O20-O27
Main Authors: Luckring, Emilee J., Ham, Kathleen, Adin, Christopher A., McLoughlin, Mary A., Stull, Jason W.
Format: Article
Language:English
Subjects:
Animals
Cadaver
Dogs
Female
Laparoscopy - methods
Laparoscopy - veterinary
Urethra - physiology
Urethra - surgery
Urinary Sphincter, Artificial - veterinary
Urodynamics
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Summary:Objective To describe a laparoscopic approach for placement of a percutaneously controlled artificial urethral sphincter (AUS) in female cadaver dogs and compare the change in urethral pressure and lumen diameter after filling the device. Study Design Experimental study. Animals Canine female cadavers (n = 10). Methods A laparoscopic technique was used to implant the AUS in 10 cadaver dogs. Maximum urethral closure pressure (MUCP), cystourethral leak point pressure (CLPP), and urethral luminal area were measured at 0, 25, 50, and 75% cuff inflation. Necropsy was performed after urethral pressure profilometry and cystoscopy data collection to assess for trauma caused by the procedure. Results Laparoscopic implantation was performed successfully in all 10 cadavers with no evidence of inadvertent trauma. Median MUCP at 0% AUS fill (48.9 cmH2O) was significantly lower than 75% fill (243.5 cmH2O). Median CLPP at 0% fill (5.0 cmH2O) was significantly lower than 75% fill (23.2 cmH2O). Significant differences were also found comparing urodynamic values 25 to 50%, 25 to 75%, and 50 to 75%. Cystoscopic evaluation revealed progressive decreases in urethral lumen area and significant differences between the urethral luminal area values as the AUS cuff was inflated. Conclusion Laparoscopic placement of an AUS can be performed successfully in cadaver dogs, improved urethral pressure profile parameters, and visibly occluded the urethral lumen. Further studies of laparoscopic placement in clinical cases affected by urethral sphincter mechanism incompetence are warranted.
ISSN:0161-3499
1532-950X
DOI:10.1111/vsu.12496