Long-term outcome of the transobturator vaginal tape inside out (TVT-O) for the treatment of urethral sphincter mechanism incompetence in female dogs

Urethral sphincter mechanism incompetence (USMI) is the most common cause of acquired urinary incontinence in female dogs. Surgery is recommended if the animal does not respond to medical treatment or becomes refractory, if side effects develop or if owners are reluctant to administer long-term medication. Stress urinary incontinence in women is mainly treated surgically by vaginal placement of suburethral slings, including the transobturator vaginal tape inside out. This technique was reported in female dogs in 2010 and short-term results were promising. The objective of the present study was to evaluate the long-term outcome of the TVT-O in female dogs. TVT-O tape was inserted in 12 incontinent bitches diagnosed with USMI. Follow-up information was evaluated by a telephone questionnaire and a continence score was attributed. One year after surgery, 7 of 12 dogs were completely continent (58%). Two dogs were removed from the long-term analysis (1 dead and 1 lost). At a median follow-up time of 85 months (range 28 to 95 months), 4 /10 dogs were completely continent without medical treatment. Incontinence recurred in 6 dogs at a median time of 2 months after surgery (range 1 to 20 months). Among those, 4/6 regained continence and 2/6 had sporadic episodes of incontinence, with additional medical treatment. No postoperative complications were encountered. TVT-O alone was successful in maintaining long term continence in 40% of the dogs. Additional postoperative medical treatment was effective in restoring continence in another 40 % of dogs. TVT-O provides an alternative treatment of USMI in female dogs, that is safe and less invasive than standard surgical techniques