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犬异位输尿管的手术治疗:长期控尿的临床结果及预后因素

Surgical management of ectopic ureters in dogs: Clinical outcome and prognostic factors for long-term continence.

作者信息

Noël Stéphanie M, Claeys Stéphanie, Hamaide Annick J

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Liège, Belgium.

出版信息

Vet Surg. 2017 Jul;46(5):631-641. doi: 10.1111/vsu.12654. Epub 2017 Apr 8.

Abstract

OBJECTIVE

To determine outcomes after surgical correction of ectopic ureters (EU) and identify prognostic factors for long-term continence.

STUDY DESIGN

Retrospective study.

ANIMALS

Forty-seven dogs (36 females and 11 males).

METHODS

Medical records (1999-2016) of dogs with surgical correction of EU were reviewed. A continence score (1 = incontinent, 2 = sporadic incontinence, 3 = continent) was attributed preoperatively, at discharge, 1 month postoperatively, and at long-term evaluation.

RESULTS

Twenty-eight dogs had unilateral and 19 dogs had bilateral EU (57 intramural and 9 extramural). Nineteen dogs had a pelvic bladder. Neoureterostomy with dissection (n = 50), ureteroneocystotomy (n = 9), or nephroureterectomy (n = 7) were performed. Thirty-three dogs were neutered: 32 before or during the surgery and 1 after surgery. Colposuspension was performed during surgical correction in 15 dogs. Adjuvant medical treatment improved postoperative continence scores. Median continence scores were greater at discharge (3), at 1 month postoperatively (3), and at long-term evaluation (3) than before surgery (1). At long-term evaluation (mean 46.1 months), a score of 1 was observed in 19%, a score of 2 in 7%, and a score of 3 in 74% of the dogs.

CONCLUSION

Overall, good (score 2) to excellent (score 3) long-term outcome was achieved in 81% of dogs. Long-term continence was improved with medical treatment and neutering was not associated with an increased risk of recurrence of incontinence in this population of dogs.

摘要

目的

确定异位输尿管(EU)手术矫正后的结果,并确定长期控尿的预后因素。

研究设计

回顾性研究。

动物

47只犬(36只雌性和11只雄性)。

方法

回顾1999年至2016年接受EU手术矫正的犬的病历。术前、出院时、术后1个月和长期评估时给予控尿评分(1=失禁,2=偶发失禁,3=可控)。

结果

28只犬为单侧EU,19只犬为双侧EU(57例壁内型和9例壁外型)。19只犬有盆腔膀胱。进行了带解剖的新输尿管造口术(n=50)、输尿管膀胱吻合术(n=9)或肾输尿管切除术(n=7)。33只犬绝育:32只在手术前或手术期间绝育,1只在手术后绝育。15只犬在手术矫正期间进行了阴道悬吊术。辅助药物治疗改善了术后控尿评分。出院时(3分)、术后1个月(3分)和长期评估时(3分)的控尿评分中位数高于术前(1分)。在长期评估时(平均46.1个月),19%的犬评分为1分,7%的犬评分为2分,74%的犬评分为3分。

结论

总体而言,81%的犬获得了良好(2分)至优秀(3分)的长期结果。药物治疗改善了长期控尿,并且在这群犬中,绝育与失禁复发风险增加无关。

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