Post-neutering urethral sphincter mechanism incompetence in female dogs

Female dogs neutering is a routine surgery that aims to prevent diseases as well as to help populational control. Urinary incontinence is one of the most significant unwanted consequences following the procedure. Pharmacological treatment is recommended for such case, and alpha-adrenergic and estrogenic drugs have been the most frequent choices reported in literature. Besides, tricyclic antidepressants are also able to control clinical signs. The exact mechanism involved with this condition is not yet fully understood. Estrogen deficiency with a subsequent loss of urethral tonus is believed to trigger clinical signs. However, it is possible that other factors such as gonadotropins and gonadotropin-releasing hormone levels may play a part on this complex mechanism of the post-neutering urinary incontinence.(AU)

Post-neutering urethral sphincter mechanism incompetence in female dogs

Female dogs neutering is a routine surgery that aims to prevent diseases as well as to help populational control. Urinary incontinence is one of the most significant unwanted consequences following the procedure. Pharmacological treatment is recommended for such case, and alpha-adrenergic and estrogenic drugs have been the most frequent choices reported in literature. Besides, tricyclic antidepressants are also able to control clinical signs. The exact mechanism involved with this condition is not yet fully understood. Estrogen deficiency with a subsequent loss of urethral tonus is believed to trigger clinical signs. However, it is possible that other factors such as gonadotropins and gonadotropin-releasing hormone levels may play a part on this complex mechanism of the post-neutering urinary incontinence.

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Use of monopolar cauterization by cystoscopy for ectopic intramural ureter correction in a bitch

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a positionother than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics forsurgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show thesurgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guided monopolar cautery.Case: A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few monthsof life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profoundgrowth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Dueto a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously ofits intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostiumcould be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orientthe ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EUchannel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside theurinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed inboth ureters...

Use of monopolar cauterization by cystoscopy for ectopic intramural ureter correction in a bitch

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a positionother than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics forsurgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show thesurgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guided monopolar cautery.Case: A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few monthsof life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profoundgrowth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Dueto a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously ofits intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostiumcould be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orientthe ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EUchannel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside theurinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed inboth ureters...(AU)

Ureter ectópico extramural em um cão Labrador Retriever: relato de caso / Ectopic ureter extramural in a Labrador Retriever dog: a case report

A ectopia ureteral é uma enfermidade congênita que se caracteriza quando um ou ambos os ureteres apresentam-se inseridos fora do seu local anatômico, com a inserção ocorrendo no útero, no colo da bexiga, na uretra ou na vagina, devido a uma diferenciação anormal dos ductos mesonéfricos e metanéfricos. Nos machos, a inserção pode ocorrer também nos ductos deferentes e na próstata. A incontinência urinária é o sinal clínico mais comumente associado ao ureter ectópico. O presente relato descreve um caso de ureter ectópico extramural unilateral, em um cão da raça Labrador Retriever de sete anos de idade, corrigido cirurgicamente, e mostra a importância dos exames radiográfico contrastado e ultrassonografia.(AU)

Ureteral ectopia is a congenital disease that is characterized when one or both ureters are shown inserted outside their anatomic site, with the possible insertion in the uterus, bladder neck, the urethra or vagina due to abnormal differentiation of ducts mesonephrics and metanephrics. In males the insertion can also occur in the vas deferens and prostate. Urinary incontinence is the most common clinical sign associated with ectopic ureter. This report describes a case of unilateral extramural ectopic ureter in a dog of the Labrador Retriever breed at seven years old surgically corrected, and shows the importance of contrast radiographic examination and ultrasound.(AU)

Infecção urinária por Morganella morganii em cão jovem portador de ureter ectópico / Urinary infection by Morganella morganii in a young dog affected by ectopic ureter

Infecções do trato urinário (ITU) são enfermidades freqüentes na rotina clínica médica de animais de companhia, sendo a cistite bacteriana a causa mais comum de ITU em cães e gatos. As más-formações do trato urinário, a citar o ureter ectópico, podem predispor os animais acometidos à infecções urinárias recorrentes causadas por um mesmo patógeno, ou patógenos distintos. Morganella morganii é uma bactéria de raro isolamento em infecções urinárias de cães, sendo considerado um agente oportunista em processos infecciosos, tanto nos animais de companhia quanto nos homens. O presente relato teve por objetivo descrever o diagnóstico clínico, bem como o diagnóstico microbiológico deste microrganismo de isolamento pouco frequente, em um animal jovem portador de ureter ectópico. Apesar de tratamentos anteriores de cistite, a paciente não apresentava melhora clínica em decorrência da falta de correção da causa de base, ou seja, do ureter ectópico; que favorecia infecções recorrentes. Mesmo sendo advertida sobre as enfermidades e seus agravantes, a proprietária abandonou o tratamento da paciente, apesar da melhora clínica parcial com a terapia antibiótica de acordo com o perfil de susceptibilidade. Os resultados obtidos neste caso clínico reiteram a importância do exame de cultura e antibiograma para tratamentos das ITUs; bem como a busca de causas de base para processos infecciosos do trato urinário. Apesar do raro isolamento, Morganella morganii deve ser considerada como um importante agente causador de ITUs em animais, assim como em humanos, uma vez que as deformidades anatômicas favorecem a ascensão de patógenos, principalmente os Gram negativos habitantes do trato gastrointestinal dos animais.

Urinary tract infections (UTI) are frequent diseases in the routine of clinical medicine of companion animals and bacterial cystitis is the most common cause of UTI in dogs and cats. The bad-formations of the urinary tract, as the ectopic ureter, may predispose the affected animals to recurrent urinary infections caused by the same or different pathogens. Morganella morganii is a bacterium with rare isolation from urinary infections in dogs, and it is considered an opportunistic agent in infectious processes, both in pets as in men. This report aimed to describe the clinical diagnosis, as microbiological diagnosis of this infrequent isolation of this microorganism in a young animal carrier of ectopic ureter. Despite of previous treatments of cystitis, the patient had no clinical improvement due to the lack of correction of the baseline cause, or ectopic ureter; which favored recurrent infections. Even being warned about the diseases and its aggravating, the owner left the treatment of the patient, despite the partial clinical improvement with antibiotic therapy according to the susceptibility profile. The results obtained in this case report confirm the importance of culture and sensitivity test for treatment of UTIs; and the search for baseline causes of infectious processes of the urinary tract. Although it’s rare isolation, Morganella morganii should be considered as an important causative agent of UTI in animals as in humans, since the anatomical deformities favor the rise of pathogens, especially Gram negative inhabitants of the animals’ gastrointestinal tract.

Ureter ectópico extramural em um cão Labrador Retriever: relato de caso / Ectopic ureter extramural in a Labrador Retriever dog: a case report

A ectopia ureteral é uma enfermidade congênita que se caracteriza quando um ou ambos os ureteres apresentam-se inseridos fora do seu local anatômico, com a inserção ocorrendo no útero, no colo da bexiga, na uretra ou na vagina, devido a uma diferenciação anormal dos ductos mesonéfricos e metanéfricos. Nos machos, a inserção pode ocorrer também nos ductos deferentes e na próstata. A incontinência urinária é o sinal clínico mais comumente associado ao ureter ectópico. O presente relato descreve um caso de ureter ectópico extramural unilateral, em um cão da raça Labrador Retriever de sete anos de idade, corrigido cirurgicamente, e mostra a importância dos exames radiográfico contrastado e ultrassonografia.(AU)

Ureteral ectopia is a congenital disease that is characterized when one or both ureters are shown inserted outside their anatomic site, with the possible insertion in the uterus, bladder neck, the urethra or vagina due to abnormal differentiation of ducts mesonephrics and metanephrics. In males the insertion can also occur in the vas deferens and prostate. Urinary incontinence is the most common clinical sign associated with ectopic ureter. This report describes a case of unilateral extramural ectopic ureter in a dog of the Labrador Retriever breed at seven years old surgically corrected, and shows the importance of contrast radiographic examination and ultrasound.(AU)

Infecção urinária por Morganella morganii em cão jovem portador de ureter ectópico / Urinary infection by Morganella morganii in a young dog affected by ectopic ureter

Infecções do trato urinário (ITU) são enfermidades freqüentes na rotina clínica médica de animais de companhia, sendo a cistite bacteriana a causa mais comum de ITU em cães e gatos. As más-formações do trato urinário, a citar o ureter ectópico, podem predispor os animais acometidos à infecções urinárias recorrentes causadas por um mesmo patógeno, ou patógenos distintos. Morganella morganii é uma bactéria de raro isolamento em infecções urinárias de cães, sendo considerado um agente oportunista em processos infecciosos, tanto nos animais de companhia quanto nos homens. O presente relato teve por objetivo descrever o diagnóstico clínico, bem como o diagnóstico microbiológico deste microrganismo de isolamento pouco frequente, em um animal jovem portador de ureter ectópico. Apesar de tratamentos anteriores de cistite, a paciente não apresentava melhora clínica em decorrência da falta de correção da causa de base, ou seja, do ureter ectópico; que favorecia infecções recorrentes. Mesmo sendo advertida sobre as enfermidades e seus agravantes, a proprietária abandonou o tratamento da paciente, apesar da melhora clínica parcial com a terapia antibiótica de acordo com o perfil de susceptibilidade. Os resultados obtidos neste caso clínico reiteram a importância do exame de cultura e antibiograma para tratamentos das ITUs; bem como a busca de causas de base para processos infecciosos do trato urinário. Apesar do raro isolamento, Morganella morganii deve ser considerada como um importante agente causador de ITUs em animais, assim como em humanos, uma vez que as deformidades anatômicas favorecem a ascensão de patógenos, principalmente os Gram negativos habitantes do trato gastrointestinal dos animais.(AU)

Urinary tract infections (UTI) are frequent diseases in the routine of clinical medicine of companion animals and bacterial cystitis is the most common cause of UTI in dogs and cats. The bad-formations of the urinary tract, as the ectopic ureter, may predispose the affected animals to recurrent urinary infections caused by the same or different pathogens. Morganella morganii is a bacterium with rare isolation from urinary infections in dogs, and it is considered an opportunistic agent in infectious processes, both in pets as in men. This report aimed to describe the clinical diagnosis, as microbiological diagnosis of this infrequent isolation of this microorganism in a young animal carrier of ectopic ureter. Despite of previous treatments of cystitis, the patient had no clinical improvement due to the lack of correction of the baseline cause, or ectopic ureter; which favored recurrent infections. Even being warned about the diseases and its aggravating, the owner left the treatment of the patient, despite the partial clinical improvement with antibiotic therapy according to the susceptibility profile. The results obtained in this case report confirm the importance of culture and sensitivity test for treatment of UTIs; and the search for baseline causes of infectious processes of the urinary tract. Although its rare isolation, Morganella morganii should be considered as an important causative agent of UTI in animals as in humans, since the anatomical deformities favor the rise of pathogens, especially Gram negative inhabitants of the animals gastrointestinal tract.(AU)

Is previous experience in laparoscopic necessary to perform robotic radical prostatectomy? A comparative study with robotic and the classic open procedure in patients with prostate cancer

PURPOSE: To assess comparative results of robot-assisted radical laparoscopic prostatectomy (RARP) performed by surgeons without any experience in laparoscopic prostatectomy and the open procedure performed by surgeons with large experience. METHODS: We analyzed 84 patients (50 subjected to robotic surgery) from June 2012 to September 2013. Data were prospectively collected in a customized database. Two surgeons carried out all the RARP cases. These two surgeons and six more performed the open cases. The perioperative outcomes between the two groups were analyzed with a minimum followup of 12 months. RESULTS: The corporal mass index (BMI) was higher in the open group (p=0.001). There was more operatve time, less hospitalization and blood loss, better trifecta and pentafecta and earlier continence (p=0.045) in the robotic group (p=0.001). There was no difference in positive surgical margins but with greater extraprostatic extension in the open group (p=0.002). CONCLUSIONS: Robot-assisted radical prostatectomy is a safe procedure even in the hands of surgeons with no previous experience. Besides this, better operative outcomes can be reached with this modern approach.(AU)

Effect of mesenchymal stem cells on movement and urination of rats with spinal cord injury / Efeitos da aplicação das células-tronco mesenquimais sobre a locomoção e micção de ratos submetidos à lesão medular

Cell therapy has frequently been reported as a possible treatment for spinal trauma in humans and animals; however, without pharmacologically curative action on damage from the primary lesion. In this study, we evaluated the effect of administering human adipose-derived stem cells (hADSC) in rats after spinal cord injury. The hADSC were used between the third and fifth passages and a proportionof cells were transduced for screening in vivo after transplantation. Spinal cord injury was inducedwith a Fogarty catheter no. 3 inserted into the epidural space with a cuff located at T8 and filled with 80-μL saline for 5 min. The control group A (n = 12) received culture medium (50 μL) and group B (n = 12) received hADSC (1.2 × 106) at 7 and 14 days post-injury, in the tail vein. Emptying of thebladder by massage was performed daily for 3 months. Evaluation of functional motor activity was performed daily until 3 months post-injury using the Basso-Beattie-Bresnahan scale. Subsequently, the animals were euthanized and histological analysis of the urinary bladder and spinal cord was performed. Bioluminescence analysis revealed hADSC at the application site and lungs. There was improvement of urinary bladder function in 83.3% animals in group B and 16.66% animals in group A. The analysis of functional motor activity and histology of the spinal cord and urinary bladder demonstrated nosignificant difference between groups A and B. The results indicate that transplanted hADSC improved urinary function via a telecrine mechanism, namely action at a distance.(AU)

A terapia celular tem sido reportada como possibilidade de tratamento para os traumas medulares, frequentes em pessoas e em animais, e que não apresentam cura farmacológica para danos advindos da lesão primária. Foram avaliados os efeitos da aplicação de células-tronco derivadas do tecido adiposo humano (hADSC) em ratos Wistar após lesão medular. As hADSC foram cultivadas, utilizadas entre aterceira e quinta passagens e parte delas foi transduzida para o rastreamento in vivo após o transplante. A lesão medular foi realizada com cateter de Fogarty nº. 3, introduzido no espaço epidural, com cuff localizado em T8 e preenchido com 80 μL de solução salina, por 5 minutos. Os animais do grupocontrole (A, n=12) receberam aplicações de meio de cultura (50 μL) e o grupo B (n=12) recebeu duas aplicações de hADSC (1,2 x 106), sete e 14 dias pós-lesão, ambas na veia da cauda. O esvaziamento vesical, por massagem, foi efetuado diariamente, durante três meses. As avaliações motoras foramrepetidas, diariamente, até três meses pós-lesão, utilizando a escala Basso-Beattie-Bresneham. Após este período os animais foram submetidos à eutanásia e foram realizadas análises histológicas de bexigaurinária e medula espinhal. As análises de bioluminescência revelaram hADSC no local da aplicação e nos pulmões. Houve melhora da função da bexiga urinária em 83,3% dos animais do grupo B e 16,66% dos animais do grupo A. A análise das avaliações motoras e histológicas das medulas espinhais e bexigas urinárias não demonstrou diferenças significativas entre os grupos A e B. Os resultados indicam que as hADSC transplantadas influenciaram a micção, de forma benéfica, por um mecanismo de açãoà distância, telécrino.(AU)

Ureter ectópico extramural em cadela / Extramural Ectopic Ureter in a Bitch

Background: Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters, in which the ureteral orifice is located distal to the trigone of the bladder. Ureteral ectopia results from dysembryogenesis of the ureteral bud due to its abnormal positioning along the mesonephric duct. It is frequently associated with other congenital anomalies of the lower urinary tract as urethral sphincter dysfunction, hydroureter and hydronephrosis. Ectopic ureters are classified into two categories: extramural and intramural. Extramural ectopic ureters completely bypass the urinary bladder without anatomic attachment, opening directly into the urethra, vagina or uterus. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia, and it is far more frequent in young bitches than in male dogs. Repositioning the distal segment of the ureter and ureteral orifice directly into the bladder may restore urinary continence throughout neoureterocistostomy. Case: A 3-month-old female poodle weighting 4 kg was referred to the Teaching Veterinary Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS), State of Rio Grande do Sul, Brazil, due to urinary incontinence, dysuria and severe vulvar pyodermatitis since it was 9 weeks old. Normal posturing and voiding of urine did occur, although only small volumes of urine were eliminated. Abdominal ultrasound revealed hydronephrosis and hydroureter of both right kidney and ureter. The ureter terminated distal to the urinary bladder, although the exact location of the termination could not be determined, ectopic ureter was suggested. Exploratory celiotomy was performed in order to confirm the diagnosis and obtain surgical correction. During the surgery it was possible to identify the hydroureter attaching on the distal urethra bypassing the bladder. Surgical correction was performed using the standard neoureterocistostomy technique. Recovery was uncomplicated and lasted 4 weeks, certified with weekly ultrasound exams. Discussion: Although ureteral ectopia has been reported in both purebred and mixed breed dogs, it has been documented to occur with greater frequency in specific breeds such as toy poodle, as observed in this case. Urinary incontinence, as observed, is the most frequently reported clinical symptom of patients with ureteral ectopia. Physical examination is often within normal limits with the exception of moist or urine-stained hair in the perivulvar region. Mild to severe perivulvar dermatitis secondary to urine scalding are commonly reported clinical signs, and were present in this case. Ultrasound examination was an efficient method to identify anatomic anomalies of the inferior urinary tract leading correctly to an exploratory celiotomy, in order to both confirm and correct the congenital defect. The neoureterocistostomy was satisfactory to reimplant the ureter on the bladder without complications. The degree of urinary incontinence is variable and cannot be used to determine the specific location of the ureteral orifice, or distinguish between the presence of unilateral or bilateral ectopic ureters and cannot exclude other differential diagnosis. Incontinence in male dogs with this affection may not occur as commonly due to the longer external urethral sphincter that may oppose the passage of urine distally, resulting in retrograde bladder filling. Surgical prognosis and recovery was good considering the patient had no other clinical affections.

Extramural ectopic ureter in a bitch / Ureter ectópico extramural em cadela

Background: Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters, in which the ureteral orifi ce is located distal to the trigone of the bladder. Ureteral ectopia results from dysembryogenesis of the ureteral bud due to its abnormal positioning along the mesonephric duct. It is frequently associated with other congenital anomalies of the lower urinary tract as urethral sphincter dysfunction, hydroureter and hydronephrosis. Ectopic ureters are classifi ed into two categories: extramural and intramural. Extramural ectopic ureters completely bypass the urinary bladder without anatomic attachment, opening directly into the urethra, vagina or uterus. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia, and it is far more frequent in young bitches than in male dogs. Repositioning the distal segment of the ureter and ureteral orifi ce directly into the bladder may restore urinary continence throughout neoureterocistostomy.Case: A 3-month-old female poodle weighting 4 kg was referred to the Teaching Veterinary Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS), State of Rio Grande do Sul, Brazil, due to urinary incontinence, dysuria and severe vulvar pyodermatitis since it was 9 weeks old. Normal posturing and voiding of urine did occur, although only sm

Background: Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters, in which the ureteral orifi ce is located distal to the trigone of the bladder. Ureteral ectopia results from dysembryogenesis of the ureteral bud due to its abnormal positioning along the mesonephric duct. It is frequently associated with other congenital anomalies of the lower urinary tract as urethral sphincter dysfunction, hydroureter and hydronephrosis. Ectopic ureters are classifi ed into two categories: extramural and intramural. Extramural ectopic ureters completely bypass the urinary bladder without anatomic attachment, opening directly into the urethra, vagina or uterus. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia, and it is far more frequent in young bitches than in male dogs. Repositioning the distal segment of the ureter and ureteral orifi ce directly into the bladder may restore urinary continence throughout neoureterocistostomy.Case: A 3-month-old female poodle weighting 4 kg was referred to the Teaching Veterinary Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS), State of Rio Grande do Sul, Brazil, due to urinary incontinence, dysuria and severe vulvar pyodermatitis since it was 9 weeks old. Normal posturing and voiding of urine did occur, although only sm

Lack of association between the ICIQ-SF questionnaire and the urodynamic diagnosis in men with post radical prostatectomy incontinence / Falta de associação entre o questionário ICIQ-SF e o diagnóstico nos homens portadores de incontinência urinária pós-prostatectomia radical

PURPOSE: To analyze the correlation between the "International Consultation on Incontinence Questionnaire-Short Form" (ICIQ-UISF) survey and the urodynamic findings in men with urinary incontinence (UI) following radical prostatectomy (RP). METHODS: 88 men who presented post-RP UI for a minimum of 1 year were enrolled prospectively. All answered the ICIQ-UISF survey and underwent urodynamic testing. Patients were divided in 3 Groups according to their urodynamic diagnosis: Group 1, patients with sphincteric incontinence (SI) alone; Group 2, patients with mixed UI (SI + Bladder Dysfunction (BD)); and Group 3, patients with BD alone. Data were analyzed using SPSS v16.0 software. RESULTS: There were 51 men in Group 1 (57.9%); 30 in Group 2 (34%); and 7 (7.9%) in Group 3. BD was found in 37/88 patients (42%), but it was the main cause of UI in only 14 patients (15.9%). There was no statistically significant difference among the mean ICIQ-UISFs values from groups 1, 2, or 3 (p>0.05). The symptoms of stress incontinence correlated with the urodynamic finding of SI (r = 0.59), and complaints of urinary urgency correlated with the presence of detrusor overactivity (DO) (r = 0.37), but these complaints did not predict the main cause of UI. CONCLUSION: The etiology of UI following RP cannot be predicted by the ICIQ-UISF survey. Symptoms of stress and urge incontinence predict the findings of SI and DO on urodynamic tests, but they cannot ascertain the main cause of UI. Urodynamic testing remains the gold standard to assess the etiology of post-RP UI.(AU)

OBJETIVO: Analisar a relação entre as queixas clínicas mensuradas pelo "International Consultation on Incontinence Questionnaire-Short Form" (ICIQ-UISF) e os achados urodinâmicos em homens com incontinência urinária (IU) após a prostatectomia radical (PR). MÉTODOS: 88 homens que apresentavam IU por um período mínimo de 1 ano após a PR foram incluídos prospectivamente. Todos responderam o questinário "ICIQ-UISF" e foram submetidos a avaliação urodinâmica. Os pacientes foram categorizados em 3 grupos de acordo com o diagnóstico urodinâmico: Grupo 1, pacientes com incontinência esfincteriana isolada (IE); Grupo 2, pacientes com IU mista (IE + disfunção vesical (DV)); e Grupo 3, pacientes com DV isolada. Os dados foram analisados utilizando o software SPSS v16.0. RESULTADOS: Dos 88 pacientes avaliados, após a avaliação urodinâmica, 51 homens (57,9%) apresentaram IE isolada (Grupo 1); 30 homens (34%) apresentaram IE associada a DV (Grupo 2) e 7 homens (7,9%) tinham somente DV (Grupo 3). A DV foi encontrada em 37/88 pacientes (42%), mas foi a principal causa de IU em apenas 14 pacientes (15,9%). Não houve diferença estatisticamente significativa entre os valores das médias do "ICIQ-UISFs" entre os grupos 1, 2 ou 3 (p> 0,05). Os sintomas de incontinência de esforço se correlacionaram com o diagnóstico urodinâmico de IE (r = 0,59), e as queixas de urgência miccional se correlacionaram com a presença de hiperactividade do detrusor na avaliação urodinâmica (r = 0,37), entretanto apesar da correlação encontrada, os sintomas não foram capazes de identificar a principal causa da UI . CONCLUSÃO: A etiologia da UI após a PR não pode ser previsto pelo escore de sintomas obtidos através do "ICIQ-UISF". Os sintomas de perda urinária as manobras de estresse e de urgência miccional estão relacionados a presença de IE e hiperatividade detrusora na avaliação urodinâmica, entretanto estes sintomas não conseguem identificar com segurança qual é o principal fator da IU após a PR.O teste urodinâmico continua sendo o padrão ouro para avaliar a etiologia da IU após a PR.(AU)

Ureterocele ectópica em cão: relato de caso / Ectopic ureterocele in a dog: a case report

Relataram-se o quadro clínico, o diagnóstico, o tratamento e o acompanhamento de um cão com ureterocele ectópica e hidronefrose/hidroureter associados. Após as informações obtidas nos exames laboratoriais e de diagnóstico por imagem, o animal foi submetido à ureterocelectomia e à neoureterostomia. O cão apresentou evolução favorável após a conduta terapêutica. Apesar de pouco frequente, a ureterocele deve ser considerada como diagnóstico diferencial em animais jovens com histórico de incontinência urinária.(AU)

The clinical features, diagnosis, treatment and monitoring of a dog with an ectopic ureterocele and concomitant hydronephrosis/hydroureter were reported. After the information obtained in laboratory tests and imaging diagnosis, the animal was submitted to ureterocelectomy and neoureterostomy. The dog presented a favorable evolution after the therapy. Although infrequent, the ureterocele should be considered a differential diagnosis in young animals with history of urinary incontinence.(AU)

Ectopia ureteral unilateral congênita em uma cadela Teckel Dachshund com pelagem arlequim: relato de caso / Single congenital ureteral ectopy in a female dog Teckel Dachshund with merle colour pattern: case report

O presente relato apresenta a primeira descrição de ectopia ureteral congênita na raça Teckel Dachshund, diagnosticada em uma cadela com pelagem arlequim. O animal, aos dois meses de idade, apresentava sinais de incontinência urinária e cistite bacteriana, sendo submetido a um plano diagnóstico para confirmação de ureter ectópico. A urografia excretora revelou hidroureter direito com desembocadura caudal ao trígono da bexiga. O exame físico do animal evidenciou ainda hérnia inguinal bilateral, o que reforçou a caracterização da origem congênita das alterações. Aspectos de bem-estar animal são também discutidos.(AU)

The present work reports the first description of congenital ureteral ectopy in the canine breed Teckel Dachshund, diagnosed in a female dog with merle colour pattern. The two month old animal, presented with continuous dribbling of urine and bacterial cystitis, was subjected to a diagnostic plan for ectopic ureter. The excretory urography showed a right hidroureter, which had an orifice located caudally to the trigone of the bladder. The animal also presented a bilateral inguinal hernia, which confirmed the case description as a multiple congenital anomaly condition. Animal welfare aspects are also discussed.(AU)

Ureterocele ortotópica em cadela (Canis familiaris) - relato de caso / Orthotopic ureterocele in bitch (Canis familiaris) - a case report / Ureterocele ortotópico en perra (Canis familiaris) - relato de caso

A ureterocele é uma dilatação da porção final do ureter decorrente de falha embriológica sem causa ainda definida. Foi atendida uma cadela da raça poodle de três meses de idade com queixa de incontinência urinária. Os exames de imagem foram os responsáveis pelo fechamento do diagnóstico, sendo visualizada uma dilatação cística intravesical. A técnica cirúrgica utilizada foi a ressecção da ureterocele com marsupialização das bordas, obtendo-se remissão completa dos sinais clínicos dois meses após a cirurgia. Aos dois anos de idade, a cadela permanece continente.

Ureterocele is a dilation of the final portion of the ureter, which results from an embryological failure of unknown cause. This article describes the case of a three-month-old female poodle with complaints of urinary incontinence. Imaging exams helped establish the diagnosis by disclosing an orthotopic cystic dilation. The surgical technique employed to treat the condition was resection of the ureterocele with marsupialization of the edges. Complete remission of clinical signs was achieved two months post-surgery; the dog remains continent two years after the procedure.

El ureterocele es una dilatación de la porción final del uréter provocado por una falla en su desarrollo embriológico, cuya causa aún no ha sido definida. Se atendió una perra Caniche de tres meses con cuadro de incontinencia urinaria. Los exámenes de imagen, a través de los cuales se pudo llegar al diagnóstico de la enfermedad, permitieron comprobar la presencia de una dilatación quística en el lumen vesical. En la cirugía se realizó la resección del ureterocele y marsupialización de los bordes; dos meses después de realizada la cirugía, el paciente no presentaba cuadros de incontinencia. A los dos años de edad, la perra permanece sin síntomas.

Ureterocele ortotópica em cadela (Canis familiaris) - relato de caso / Orthotopic ureterocele in bitch (Canis familiaris) - a case report / Ureterocele ortotópico en perra (Canis familiaris) - relato de caso

A ureterocele é uma dilatação da porção final do ureter decorrente de falha embriológica sem causa ainda definida. Foi atendida uma cadela da raça poodle de três meses de idade com queixa de incontinência urinária. Os exames de imagem foram os responsáveis pelo fechamento do diagnóstico, sendo visualizada uma dilatação cística intravesical. A técnica cirúrgica utilizada foi a ressecção da ureterocele com marsupialização das bordas, obtendo-se remissão completa dos sinais clínicos dois meses após a cirurgia. Aos dois anos de idade, a cadela permanece continente.(AU)

Ureterocele is a dilation of the final portion of the ureter, which results from an embryological failure of unknown cause. This article describes the case of a three-month-old female poodle with complaints of urinary incontinence. Imaging exams helped establish the diagnosis by disclosing an orthotopic cystic dilation. The surgical technique employed to treat the condition was resection of the ureterocele with marsupialization of the edges. Complete remission of clinical signs was achieved two months post-surgery; the dog remains continent two years after the procedure. (AU)

El ureterocele es una dilatación de la porción final del uréter provocado por una falla en su desarrollo embriológico, cuya causa aún no ha sido definida. Se atendió una perra Caniche de tres meses con cuadro de incontinencia urinaria. Los exámenes de imagen, a través de los cuales se pudo llegar al diagnóstico de la enfermedad, permitieron comprobar la presencia de una dilatación quística en el lumen vesical. En la cirugía se realizó la resección del ureterocele y marsupialización de los bordes; dos meses después de realizada la cirugía, el paciente no presentaba cuadros de incontinencia. A los dos años de edad, la perra permanece sin síntomas.(AU)

Surgical procedures used for post-traumatic neurogenic bladder in a cat: report case / Procedimentos cirúrgicos utilizados no tratamento da bexiga neurogênica em um gato: relato de caso

A 1-year-old castrated crossbred male cat was referred to the Veterinary Teaching Hospital for evaluation of urinary retention associated with a subluxation at T12-T13 caused by a car accident. Urethral sphincter denervation by transection of hypogastric and pudendal nerves was performed to allow bladder emptying, but after three months post operation the cat had a urinary retention recurrence. Endoscopic urethral sphincterotomy was done resulting in urinary incontinence for four months.(AU)

Um gato de um ano de idade, macho, castrado, sem raça definida, foi encaminhado ao Hospital Veterinário Escola para avaliação de retenção urinária associada à subluxação nas vértebras T12-T13, que foi causada por um acidente automobilístico. Realizou-se a denervação do esfíncter uretral, por transecção dos nervos pudendo e hipogástrico, para permitir o esvaziamento da bexiga, porém três meses após a cirurgia inicial o animal apresentou recorrência da retenção urinária. Esfincterotomia endoscópica uretral foi então realizada, resultando em incontinência urinária por quatro meses.(AU)