L’incompétence du sphincter urétral est caractérisée par une perte d’urine inconsciente surtout lorsque l’animal est couché ou endormi, ou lors de phases d’excitation. Elle affecte généralement les chiennes stérilisées, d’âge moyen, et de moyenne ou grande race. L’étiologie de cette condition est multifactorielle et les éléments prédisposants incluent une diminution du tonus urétral, la position intra-pelvienne du col vésical, un urètre court, la stérilisation, l’obésité et l’âge. Les examens complémentaires nécessaires à l’identification de la pathologie sont une vagino-urétrographie qui permet de déceler des anomalies vaginales et de visualiser l’urètre et la position du col vésical, et la profilométrie urétrale qui permet d’objectiver une diminution de la pression et de la longueur fonctionnelle urétrales. Un traitement médical à base d’oestriol peut être envisagé. Cet oestrogène à courte durée d’action ne présente pas les effets secondaires classiques. Malheureusement, son taux de succès avoisine seulement les 65 % de continence complète. Les substances _-adrénergiques (phénylpropanolamine et éphédrine) sont plus efficaces, avec un taux de succès de 75 % à 90 % et elles présentent peu d’effets secondaires. En cas d’absence de réponse au traitement médical, ou si l’animal y devient réfractaire, une colposuspension peut être proposée, avec un pronostic raisonnablement bon.
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[en] Urethral sphincter mechanism incompetence is characterized by unvoluntary urine leakage, worsening when the animal is recumbent or asleep, or during excitement. It mainly affects large breed dogs, and mostly middle-aged spayed bitches. The aetiology of this condition is multifactorial and predisposing factors include a decrease urethral tone, an intrapelvic bladder neck position, a short urethra, sterilisation, obesity, and age. Diagnostic workup should include a vaginourethrography to identify possible vaginal abnormalities and to visualize the urethra and the position of the bladder neck, and urethral profilometry to demonstrate a decrease in maximal urethral pressure and functional profile length. Medical treatment with oestriol is an option. This short-acting oestrogen does not exhibit oestrogenic side effects. Unfortunately, its success rate is only of 65 % of complete continence. The a- adrenergic agents ( phenylpropanolamine and ephedrine) are more efficacious, with a success rate reaching 75 to 90 %, with very few side effects. In absence of response to the treatment, or if the animal becomes refractory, a colposuspension can be recommended, with a fairly good prognosis.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Hamaide, Annick ; Université de Liège - ULiège > Département clinique des animaux de compagnie et des équidés > Chirurgie des Petits Animaux
Balligand, Marc; Université de Liège - ULiège > Département Clinique des Animaux de Compagnie et des Equidés > Chirurgie des Petits Animaux
Verstegen, John
Language :
French
Title :
Urethral sphincter mechanism incompetence in the bitch. Review of the literature
Alternative titles :
[fr] L’incompétence du sphincter urétral chez la chienne. Revue de la littérature
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