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Veterinary surgery : VS · Nov 2016
Laparoscopic placement and urodynamic effects of an artificial urethral sphincter in cadaveric dogs.
- Emilee J Luckring, Kathleen Ham, Christopher A Adin, Mary A McLoughlin, and Jason W Stull.
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
- Vet Surg. 2016 Nov 1; 45 (S1): O20-O27.
ObjectiveTo 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 DesignExperimental study.AnimalsCanine female cadavers (n = 10).MethodsA 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.ResultsLaparoscopic implantation was performed successfully in all 10 cadavers with no evidence of inadvertent trauma. Median MUCP at 0% AUS fill (48.9 cmH2 O) was significantly lower than 75% fill (243.5 cmH2 O). Median CLPP at 0% fill (5.0 cmH2 O) was significantly lower than 75% fill (23.2 cmH2 O). 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.ConclusionLaparoscopic 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.© Copyright 2016 by The American College of Veterinary Surgeons.
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