William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, California, USA.
Department of Veterinary Medicine and Epidemiology, University of California, Davis, California, USA.
J Vet Intern Med. 2022 Sep;36(5):1700-1707. doi: 10.1111/jvim.16501. Epub 2022 Aug 19.
Cystourethroscopy and vaginoscopy (uroendoscopy) is often used in the diagnostic evaluation of dogs with lower urinary tract disorders (LUTD).
OBJECTIVE/HYPOTHESIS: To evaluate if uroendoscopy is warranted in dogs with various LUTD, the agreement between uroendoscopic and ultrasonographic diagnoses were compared. Dogs with recurrent urinary tract infections (rUTI) will have the highest diagnostic agreement between uroendoscopy and ultrasonography (US) compared to dogs presenting for other LUTD.
Two hundred thirty-seven dogs presenting between 2014 and 2019 with lower urinary tract signs (LUTS) that had US within 60 days preceding uroendoscopy.
Retrospective study. Dogs were categorized by primary indication for ultrasound. Pertinent uroendoscopic findings were recorded and agreements (κ analysis) between the final uroendoscopic diagnosis were compared with the final ultrasonographic diagnosis.
Pertinent uroendoscopic findings were recorded for 69/237 (29%) cases. For dogs presenting primarily for urinary incontinence (UI), agreement between uroendoscopy and US was 71% (46/65; κ = 0.47, 95% CI 0.28-0.66), for dogs with stranguria, 58% (29/50; κ = 0.47, 95% CI 0.31-0.62) and for dogs with rUTI the agreement was substantial at 87% (26/30; κ = 0.70, 95% CI 0.43-0.98). Urethral strictures were the majority (14/21; 67%) of pertinent uroendoscopic findings for dogs with stranguria, of which 12 were male dogs.
Agreement between uroendoscopy and US was moderate for all dogs. Based on these data, recommendation for uroendoscopy should be tailored to individual clinical presentation and signalment; transabdominal US is not the preferred modality for urethral lesions.
膀胱尿道镜检查和阴道镜检查(uroendoscopy)常用于诊断下尿路疾病(LUTD)的犬。
目的/假设:为了评估在患有各种 LUTD 的犬中是否需要进行 uroendoscopy,比较了 uroendoscopy 和超声诊断之间的一致性。与因其他 LUTD 就诊的犬相比,患有复发性尿路感染(rUTI)的犬的 uroendoscopy 和超声(US)之间的诊断一致性最高。
2014 年至 2019 年间出现下尿路症状(LUTS)并在 uroendoscopy 前 60 天内进行 US 的 237 只犬。
回顾性研究。根据 US 的主要指征对犬进行分类。记录相关的 uroendoscopic 发现,并比较最终 uroendoscopic 诊断与最终超声诊断之间的一致性(κ 分析)。
记录了 69/237(29%)例犬的相关 uroendoscopic 发现。对于主要因尿失禁(UI)就诊的犬,uroendoscopy 和 US 之间的一致性为 71%(46/65;κ=0.47,95%CI 0.28-0.66),对于排尿困难的犬为 58%(29/50;κ=0.47,95%CI 0.31-0.62),对于 rUTI 的犬则为 87%(26/30;κ=0.70,95%CI 0.43-0.98)。排尿困难犬的主要 uroendoscopic 发现是尿道狭窄(21 例中的 14 例;67%),其中 12 例为雄性犬。
所有犬的 uroendoscopy 和 US 之间的一致性为中度。根据这些数据,uroendoscopy 的推荐应根据个体临床表现和特征量身定制;经腹 US 不是尿道病变的首选方式。