Urinary

Question 1

Urinary incontinence is defined as

Answer 1

Involuntary leakage from the bladder during the storage phase of micturition

Question 2

Congenital causes of urinary incontinance

Answer 2

1. ectopic ureters
2. USMI
3. bladder hypoplasia
4. patent urachus

Question 3

Acquired causes of urinary incontinance

Answer 3

1. USMI
2. Overflow incontinence - excessively large flaccid or tense bladder.
3. UTI
4. detrusor hyperexcitability
5. PU/PD - excessive challange

Question 4

Best way to diagnose ectopic ureters

Answer 4

Cystoscopy

Question 5

Only positive test for USMI

Answer 5

Urodynamics - urethral pressure profile - see a flatline where you would normally see muscle contractions.

Question 6

Overflow incontinance can be caused by

Answer 6

Neurological conditions, bladder atony, urethral/bladder neck obstruction

Question 7

Acquired USMI

Answer 7

Usually post neutering - alteration in hormonal influences & collagen:muscle ratio in urethral wall.

Question 8

Tx options intramural ectopic ureters

Answer 8

1. cystic laser ablation
2. side-side neoureterostomy
3. urethral re-implantation
4. ureteronecphrectomy (salvage)

Question 9

Tx options for extramural ectopic ureters

Answer 9

Urethral re-implantation

Ureteronephrectomy

Question 10

USMI medical treatment

Answer 10

1. Phenylpropanolamine

2. oestriol (neutered only)

Question 11

USMI surgical options

Answer 11

1. relocation of bladder neck - when dog lies down pressure is on both bladder & neck - reduced urine leakage.
   - colposuspension more common option - permanent sutures between vaginal wall and prepubic tendon.
2. artificial urethral spincter - 6wks recovery then cuff inflated - incremental increase if incontinence persists.