Urinary incontinence, vaginitis, stranguria, and recurrent urinary tract infections (UTIs) are common in bitches. Clinical signs are often attributed to conformational abnormalities. Direct examination of the vagina and urethra is limited to the extent of the urogenital tract that can be evaluated digitally or endoscopically. In this retrospective study, records and client follow-up were reviewed for 38 spayed female dogs initially evaluated via excretory urography. Dogs with treatment via vulvoplasty were put in group 1 and dogs without vulvoplasty in group 2. Clinical signs, results of radiography, and response to surgical or medical treatment were analyzed. Influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for UTIs was investigated. Vestibulovaginal stenosis with a ratio less than 0.20 was significantly associated with a negative response to treatment. Dogs without severe vestibulovaginal stenosis that received vulvoplasty for a recessed vulva responded well to treatment. Lower UTIs, incontinence, and pelvic bladder were not associated with response to treatment for recessed vulva.
Vestibulovaginal stenosis is likely an important factor in UTI treatment outcome for dogs with a vestibulovaginal ratio less than 0.20. Vaginectomy or resection and anastomosis should be considered in dogs with severe vestibulovaginal stenosis and signs of lower urinary tract disease, although further study is needed to determine the benefits of this strategy.
COMMENTARY: Severe vestibulovaginal stenosis in spayed female dogs (defined as a ratio < 0.20 of the maximal diameter of the distended vagina on retrograde vaginocystourethrography) is associated with poor response to treatment for signs of UTIs, incontinence, and vaginitis. The reason for this outcome is unknown, but the stenotic area may be predisposed to urine pooling in the vagina cranial to the stenotic section. This study also further confirms the efficacy of vulvoplasty as an effective adjunct therapy for patients with concurrent vulval involution and UTI.
Influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs: 38 cases (1990-1999). Crawford JT, Adams WA. JAVMA 221:995-999, 2002.