• 1. Szabo S, Wilkens B, Radasch RM. Use of polypropylene mesh in addition to internal obturator transposition: a review of 59 cases (2000–2004). J Am Anim Hosp Assoc 2007; 43: 136142.

    • Search Google Scholar
    • Export Citation
  • 2. White RAS, Herrtage ME. Bladder retroflexion in the dog. J Small Anim Pract 1986; 27: 735746.

  • 3. Mahaffey MB, Barsanti JA, Barber DL, et al. Pelvic bladder in dogs without urinary incontinence. J Am Vet Med Assoc 1984; 184:14771479.

    • Search Google Scholar
    • Export Citation
  • 4. Gregory SP, Cripps PJ, Holt PE. Comparison of urethral pressure profilometry and contrast radiography in the diagnosis of incompetence of the urethral sphincter mechanism in bitches. Vet Rec 1996; 138: 5861.

    • Search Google Scholar
    • Export Citation
  • 5. Adams WM, DiBartola SP. Radiographic and clinical features of pelvic bladder in the dog. J Am Vet Med Assoc 1983; 182: 12121217.

  • 6. Jackson DA, Brasmer TH, Stevens JB. Experimental use of fluoroalkyl cyanoacrylate in canine urethral anastomosis. Vet Surg 1980; 9: 1319.

    • Search Google Scholar
    • Export Citation
  • 7. White RN. Urethropexy for the management of urethral sphincter mechanism incompetence in the bitch. J Small Anim Pract 2001; 42: 481486.

    • Search Google Scholar
    • Export Citation
  • 8. Porena M, Costantini E, Lazzeri M. Mixed incontinence: how best to manage it? Curr Bladder Dysfunct Rep 2013; 8: 712.

  • 9. Pirpiris A, Shek KL, Dietz HP. Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol 2010; 36: 507511.

  • 10. Dietz HP, Clarke B, Herbison P. Bladder neck mobility and urethral closure pressure as predictors of genuine stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2002; 13: 289293.

    • Search Google Scholar
    • Export Citation
  • 11. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010; 29: 420.

    • Search Google Scholar
    • Export Citation
  • 12. Smith PP, Appell RA. Pelvic organ prolapse and the lower urinary tract: the relationship of vaginal prolapse to stress urinary incontinence. Curr Urol Rep 2005; 6: 340347.

    • Search Google Scholar
    • Export Citation
  • 13. Ellerkmann RM, Cundiff GW, Melick CF, et al. Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 2001; 185: 13321337, discussion 1337–1338.

    • Search Google Scholar
    • Export Citation
  • 14. Marinkovic SP, Stanton SL. Incontinence and voiding difficulties associated with prolapse. J Urol 2004; 171: 10211028.

  • 15. Ghoniem GM, Walters F, Lewis V. The value of the vaginal pack test in large cystoceles. J Urol 1994; 152: 931934.

  • 16. McClanahan SL, Malone ED, Anderson KL. Bladder outlet obstruction in a 6-month-old alpaca secondary to pelvic displacement of the urinary bladder. Can Vet J 2005; 46: 247249.

    • Search Google Scholar
    • Export Citation

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Treatment of urethral obstruction secondary to caudal bladder displacement, trigonal invagination, and urethral kinking in a dog

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  • 1 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 4 Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

CASE DESCRIPTION A 15-year-old spayed female mixed-breed dog was evaluated for a 7-week history of stranguria, pollakiuria, and intermittent urethral obstruction.

CLINICAL FINDINGS On initial evaluation, the patient had persistent stranguria with lack of urine production; after multiple unsuccessful attempts to urinate, a large volume of urine was produced. Prior to voiding the large volume, the urinary bladder was not palpable during examination. Abdominal ultrasonography confirmed caudal displacement of the urinary bladder, and the urethra and trigone could not be located ultrasonographically. Positive-contrast cystourethrography and CT confirmed caudal displacement of the urinary bladder and also revealed trigonal invagination and urethral kinking; dysuria was attributed to these findings.

TREATMENT AND OUTCOME Surgical repositioning of the lower urinary tract was performed. The urinary bladder was moved cranially and was fixed in place along the left lateral aspect of the body wall by cystopexy. After surgery, positive-contrast cystourethrography revealed a more cranial positioning of the urinary bladder and straightening of the urethra with no urethral kinking or trigonal invagination. Immediately after surgery, stranguria had resolved and the patient was able to void normally. Two years after surgery, the dog was reported to be urinating normally.

CLINICAL RELEVANCE Surgical correction of caudal urinary bladder displacement with cystopexy led to resolution of trigonal invagination, urethral kinking, and urethral obstruction in the dog of the present report. Trigonal invagination and urethral kinking, although uncommon findings, should be considered as possible causes of dysuria in dogs.

Abstract

CASE DESCRIPTION A 15-year-old spayed female mixed-breed dog was evaluated for a 7-week history of stranguria, pollakiuria, and intermittent urethral obstruction.

CLINICAL FINDINGS On initial evaluation, the patient had persistent stranguria with lack of urine production; after multiple unsuccessful attempts to urinate, a large volume of urine was produced. Prior to voiding the large volume, the urinary bladder was not palpable during examination. Abdominal ultrasonography confirmed caudal displacement of the urinary bladder, and the urethra and trigone could not be located ultrasonographically. Positive-contrast cystourethrography and CT confirmed caudal displacement of the urinary bladder and also revealed trigonal invagination and urethral kinking; dysuria was attributed to these findings.

TREATMENT AND OUTCOME Surgical repositioning of the lower urinary tract was performed. The urinary bladder was moved cranially and was fixed in place along the left lateral aspect of the body wall by cystopexy. After surgery, positive-contrast cystourethrography revealed a more cranial positioning of the urinary bladder and straightening of the urethra with no urethral kinking or trigonal invagination. Immediately after surgery, stranguria had resolved and the patient was able to void normally. Two years after surgery, the dog was reported to be urinating normally.

CLINICAL RELEVANCE Surgical correction of caudal urinary bladder displacement with cystopexy led to resolution of trigonal invagination, urethral kinking, and urethral obstruction in the dog of the present report. Trigonal invagination and urethral kinking, although uncommon findings, should be considered as possible causes of dysuria in dogs.

Contributor Notes

Dr. Korner's present address is Southern California Veterinary Specialty Hospital, Irvine, CA 92614.

Address correspondence to Dr. Palm (cpalm@ucdavis.edu).