Utilisation d'un sphincter urinaire hydraulique dans le traitement d'une incontinence urinaire réfractaire après chirurgie d'uretères ectopiques sur une chienne

An 8-month-old Labrit was referred for urinary incontinence since the adoption. A bilateral ectopic uretera is diagnosed and a neo-ureterostostomia is performed. The persistence of incontinence leads to a urethral sphincter incompetence suspicion and a medical treatment (phenylpropanolamine) is prescribed with a partial remission of the urinary incontinence. An artificial urethral sphincter is then proposed and installed surgically. Fifteen months later, the dog is still continent and no complications are noted. This article describes the different treatments available in veterinary medicine for urinary incontinence. Medical or surgical treatments can be proposed, depending on the cause of urinary incontinence. As far as the ectopic uretera is concerned, 40 to 67% of the animals remain incontinent after surgery. The association of a surgical and a medical treatment tend to improve continence scoring. For refractory cases, new surgical techniques have to be proposed. Since 2004, hydraulic urethral sphincters have shown very promising results (improvement of urinary incontinence in 100% of the cases, three months after surgery). They are an interesting alternative for refractory cases to classical treatments of urethral sphincter incompetence.