对患有难治性尿失禁的雌性犬进行同步利尿膀胱尿道测压和多通道尿道压力测定

Simultaneous diuresis cysto-urethrometry and multi-channel urethral pressure profilometry in female dogs with refractory urinary incontinence.

作者信息

Nickel R F, van den Brom W

机构信息

Department of Clinical Sciences of Companion Animals, University of Utrecht, The Netherlands.

出版信息

Am J Vet Res. 1997 Jul;58(7):691-6.

PMID:9215440

Abstract

OBJECTIVE

To assess urethral closure and bladder storage function in female dogs with refractory urinary incontinence by use of simultaneous diuresis cysto-urethrometry (UCM) and multi-channel urethral pressure profilometry (UPP).

ANIMALS

53 female dogs of various breeds with a history of 'non-neurogenic,' acquired urinary incontinence unresponsive to standard conservative treatment.

PROCEDURE

UPP and UCM were performed on dogs sedated with xylazine, using a flexible polyvinylchloride multi-channel catheter connected to a perfusion system. Urine production was determined by use of radionucleotide dilution analysis. Values of reproducible urodynamic variables obtained previously in clinically normal dogs were compared with findings in the incontinent dogs. Cutoff values with the highest predictive values of urodynamic variables were determined and selected for functional classification.

RESULTS

Except for threshold volume, median values of all urodynamic variables were significantly different between continent and incontinent dogs. Urethral pressure values, their relative variation, bladder threshold pressure, and prevalence of detrusor contractions were significantly lower than values in normal dogs, but compliance was higher. Forty-one dogs had urodynamic findings suggestive of poor urethral closure function assessed by UCM, but 10 of these had normal closure pressure values during UPP. Abnormal bladder storage function was interpreted from the findings of 19 dogs. Low capacity was found in 3, low threshold pressure in 15, and high compliance in 9 dogs. Seven of the dogs with abnormal bladder storage function had normal urethral closure function assessed by UPP and UCM. Five dogs had no abnormal findings, and 1 continent dog was abnormal by our classification.

CONCLUSIONS

Abnormal bladder storage function was suggested in a considerable number of dogs with refractory urinary incontinence.

摘要

目的

通过同步利尿膀胱尿道测压法（UCM）和多通道尿道压力测定法（UPP）评估难治性尿失禁母犬的尿道闭合及膀胱储尿功能。

动物

53只不同品种的母犬，有“非神经源性”后天性尿失禁病史，对标准保守治疗无反应。

方法

使用连接到灌注系统的柔性聚氯乙烯多通道导管，对用赛拉嗪镇静的犬进行UPP和UCM检查。通过放射性核素稀释分析确定尿量。将先前在临床正常犬中获得的可重复尿动力学变量值与失禁犬的检查结果进行比较。确定并选择具有最高尿动力学变量预测值的临界值进行功能分类。

结果

除阈值容量外，所有尿动力学变量的中位数在有控尿能力和失禁犬之间均有显著差异。尿道压力值、其相对变化、膀胱阈值压力和逼尿肌收缩发生率均显著低于正常犬，但顺应性更高。41只犬的尿动力学检查结果提示通过UCM评估尿道闭合功能不佳，但其中10只在UPP检查时闭合压力值正常。从19只犬的检查结果中解读出膀胱储尿功能异常。3只犬容量低，15只犬阈值压力低，9只犬顺应性高。7只膀胱储尿功能异常的犬经UPP和UCM评估尿道闭合功能正常。5只犬无异常发现，1只有控尿能力的犬按我们的分类为异常。