Long-Term Outcome of Female Dogs Treated with Static Hydraulic Urethral Sphincter for Urethral Sphincter Mechanism Incompetence

ABSTRACT The purpose of the study was to report the postoperative outcome, complications, and long-term follow-up of the use of a static hydraulic urethral sphincter for the management of urethral sphincter mechanism incompetence in female dogs. Medical records were reviewed to extract information on long-term (>365 days) outcome data. Telephone owner questionnaire was performed to assess postoperative urinary continence scores (scale 1–10, where 10 is complete continence) and the presence and frequency of complications. Twenty female dogs were included. Mean (±standard deviation) time to follow-up was 1,205.1 (±627.4) days. Median continence score/10 (range) was 3.5 (2–6) preoperatively, and 9.0 (7–10) at the last follow-up. Median continence score was significantly higher at all time points postoperatively compared with before surgery (P < .001). Complete continence was achieved in 90% of bitches. Minor complications occurred in 13 bitches and included dysuria (8), bacterial cystitis (8), longer urination time (10), incisional seroma (5), urinary retention (3), hematuria (2), and pain when urinating (2). Major complications occurred in one dog (static hydraulic urethral sphincter removed 28 mo after placement). Continence scores were sustainably improved in the long-term. Complications were mostly minor. Urinary tract infections were the most common but resolved with conventional antibiotic treatment.

Comparison of functional outcome of colonic J-pouch and latero-terminal anastomosis in low anterior resection for rectal cancer

Introduction. Functional results after low anterior resection for rectal cancer are an issue of increasing attention among colorectal surgeons and others interested in this subject. The consensus on ideal reconstruction type has not been achieved to date, although the number of papers on this subject has been published in recent years. Objective. We conducted a prospective, parallel group study comparing latero-terminal with colonic J-pouch anastomosis in terms of defecatory function in patients undergoing stapled low colorectal/ coloanal anastomosis. Methods. A total of 80 patients were included in this study with either latero-terminal or colonic J-pouch anastomosis. Defecatory function was evaluated using the modified version of MSKCC questionnaire 6, 12 and 24 months after the operation. Fecal continence was evaluated using the Wexner continence score. Results. In both groups, trend towards improvement was registered in all measured variables in all three control intervals. This can apply to bowel frequency, urgency, night soiling, fragmentation and incomplete evacuation. However, the difference was not statistically significant, and when reviewing the trend of results we can note that in the J-pouch group steady state has not been reached even after 24 month control. Conclusion. This trial did not reveal any significant differences in defecatory function 6, 12 and 24 months after low anterior resection (LAR) between patients with a latero-terminal anastomosis and those with colonic J-pouch anastomosis. Our results did not confirm superiority of colonic J-pouch over the lateroterminal anastomosis.

Lateralinė sfinkterotomija išangės įplėšai gydyti: asmeninė patirtis (2000–2002 metai)

Narimantas Evaldas SamalavičiusVilniaus centro universitetinės ligoninėsChirurgijos skyriaus Koloproktologijos poskyrisŽygimantų g. 3, LT–2001 VilniusEl paštas: [email protected] Tikslas Išnagrinėti 2000–2002 metais nuo išangės įplėšos operuotų ligonių gydymo rezultatus. Ligoniai ir metodai Lateralinė sfinkterotomija atlikta 46 ligoniams: 26 moterims ir 20 vyrų. Jų amžius – nuo 31 iki 77 metų, vidurkis – 50 metų. Hospitalizacija truko nuo 1 iki 7 dienų, vidutiniškai 1,8 dienos. 24 (52,2%) ligoniai operuoti taikant vietinę, 17 (37%) – bendrąją, 3 (6,5%) – spinalinę ir 2 (4,3%) – epidurinę nejautrą. 14 (30,4%) ligonių atliktos simultaninės operacijos. Komplikacijų nebuvo. Visiems ligoniams 2003 metų vasarį išsiųsti klausimynai. Rezultatai Apklausoje dalyvavo 28 (60,1%) ligoniai iš 46 operuotųjų. Chirurginiu gydymu buvo patenkinti 27 (96,4%) ligoniai, o nepatenkintas – vienas (3,6%). Po operacijos 21 (75%) ligoniui skundai visiškai išnyko, 4 (14,2%) nurodė diskomfortą išangės srityje, o 3 ligoniai (10,7%) – tam tikro intensyvumo išangės skausmą ir kraujavimą. Sutrikusia po operacijos išangės raukų funkcija skundėsi iš viso 3 (10,7%) ligoniai. Pagal Klivlendo išmatų nelaikymo klasifikaciją, vienam ligoniui išmatų nelaikymas įvertintas 1 balu, vienam – 2 balais ir vienam – 4 balais. Išvados Lateralinė sfinkterotomija yra saugi ir veiksminga operacija išangės įplėšai gydyti. Kadangi kai kuriems ligoniams po operacijos pasireiškia nors ir nedidelis išmatų nelaikymas, prieš taikant chirurginį gydymą būtina išbandyti konservatyvaus gydymo priemones. Prasminiai žodžiai: išangės įplėša, lateralinė sfinkterotomija, rezultatai, išmatų nelaikymas Lateral sphincterotomy for anal fissure: personal experience (2000–2002) Narimantas Evaldas Samalavičius Objective The aim of the study was to evaluate the long-term results after lateral sphincterotomy for anal fissure for the period January 2000 to December 2002. Patients and methods Operated on were 46 patients (26 women and 20 men, age range 31–77, mean 50 years). In-hospital stay lasted 1 to 7 days, mean 1.8 days. Twenty-four patients (52.2%) were operated on under local, 17 (37%) under general, 3 (6.5%) under spinal and 2 (4.3%) under epidural anesthesia; 14 (30.4%) patients underwent simultaneous anorectal surgery. No complications occurred. All patients received a questionnaire by mail in February 2003. Results Of 46 patients, 28 (60.1%) responded, of them 27 (96.4%) were satisfied with the results of surgery and 1 (3.6%) was not. Twenty-one patients (75%) noted a full resolution of symptoms, 4 (14.2%) noted a minor anal discomfort and 3 (10.7%) a certain degree of anal pain and haemorrhage. Anal incontinence was present in 3 (10.7%) cases: according to Celveland Continence Score, 1 point in one case, 2 points in one case and 4 points in one case. Conclusions Lateral sphincterotomy was a safe and effective surgical option for anal fissure. As in some patients certain loss of anal control is unavoidable, conservative mesures should be administered prior to surgical treatment. Keywords: anal fissure, lateral sphincterotomy, results, incontinence