Optimum anesthesia for reliable urethral pressure profilometry in female dogs and goats

Abstract

Abbreviations & Acronyms C r = repeatability coefficient C RR = coefficient of reproducibility between occasions CV within = within-subject coefficient of variation FA = functional area FUL = functional urethral length MUCP = maximal urethral closure pressure NS = not significant S w = within-subject standard deviation UPP = urethral pressure profilometry Objectives: To investigate the effects of propofol and isoflurane on urethral pressure profilometry of female dogs and goats, and to identify the method of anesthesia that least influences urethral pressure profilometry and to assess its reproducibility. Methods: The effects of premedication with midazolam, propofol sedation and isoflurane anesthesia were assessed in five female dogs. The effects of propofol and isoflurane were compared in seven goats, whereas in another group of 19 goats, the state of deep propofol sedation was compared with the state of recovery from propofol sedation. The coefficient of reproducibility and within-subject coefficient of variation were calculated to evaluate test-retest reproducibility. Results: In conscious female dogs, maximal urethral closure pressure and functional area were significantly higher than under propofol or isoflurane (P = 0.04), but not different from the recovery state. In six of seven goats, maximal urethral closure pressure and functional area were higher when measured under propofol sedation than under isoflurane (median maximal urethral closure pressure, 69 vs 47 cmH 2 O; P = 0.03). Maximal urethral closure pressure was lower under propofol than during recovery from propofol in 17 of 19 goats (median maximal urethral closure pressure, 54 vs 66 cmH 2 O; P < 0.001). The test-retest coefficient of reproducibility for goats was 28 cmH 2 O, and the within-subject coefficient of variation was 16%. Conclusions: In dogs, urethral pressure profilometry should be measured in conscious animals whenever possible. In goats, urethral pressure profilometry is least affected during recovery from propofol sedation, and it shows acceptable reproducibility under this condition.

Intraurethral co-transplantation of bone marrow mesenchymal stem cells and muscle-derived cells improves the urethral closure

“…The static UPP was determined on animals placed in sternal recumbency. The measurements were carried out during recovery from propofol action in a state of light anesthesia (palpebral reflex present) as our group has previously shown that this kind of anesthesia only moderately affects the UPP measurements [ 17 ]. A twin-lumen catheter (6Fr, Laborie) with side holes was withdrawn from the bladder and the urethra at a constant speed of 2.5 mm/s.…”

Limited accuracy of transurethral and periurethral intrasphincteric injections of cellular suspension

“…Although these animals have not been previously used for testing of intraurethral cell therapy, we have demonstrated that caprine female urethra and EUS have similar parameters to those reported in women . Our group has experience in working with pigs and dogs, and we postulate that goats are the most adequate large experimental quadreped animals for testing of intraurethral manipulations. An interesting alternative could be minipigs used by Amend et al but the porcine female urethra (even in minipigs) is much longer than in humans, which creates different conditions for needle insertion both in peri‐ and transurethral injections.…”

“…Static urethral pressure profilometry was performed on animals placed in a sternal recumbency restraint during recovery from propofol sedation in a way described previously by our group . The parameters which were important for transplantation procedure were 1) the functional urethral length (FUL) and 2) the distance from the beginning of UPP to maximal urethral closure pressure (MUCP) point as a percentage of FUL which corresponded to the location of maximal EUS strength in the longitudinal axis of the analyzed urethra.…”

Large Animal Models for Investigating Cell Therapies of Stress Urinary Incontinence

“…Urinary continence is therefore partially under somatic neuronal control. When determining incontinence by measuring the urethral wall pressure in animals in sedation versus deep anesthesia, significant differences were noted disclosing the contribution of the neuronal control and striated muscles to the overall closure pressure [ 36 ]. The contribution of passive forces such as tissue tension, blood pressure to the overall continence is noticed, when urodynamics are measured in animals in anesthesia and upon sacrifice (unpublished observation).…”