Urinary incontinence secondary to a suspected congenital urethral deformity in a kitten

Abstract

Case summary A 5-month-old entire male domestic shorthair kitten was referred for investigation of a month-long history of urinary incontinence. Clinical examination, baseline blood work and imaging (plain radiography and ultrasonography) were unremarkable. Urinalysis documented a urinary tract infection and a retrograde urethrocystogram revealed an outpouching of the pelvic urethra. Surgical exploration revealed the absence of the dorsal portion of the urethral wall in this section of pelvic urethra, replaced by an epithelial lined expanded ‘pouch’. The ventral aspect of the urethra appeared grossly normal. A modified perineal urethrostomy was performed to create an anastomosis of the urethral pouch to the skin of the perineum alongside conventional castration. The kitten made a full recovery and the incontinence resolved within 48 h. A congenital urethral diverticulum and secondary urinary tract infection were deemed the most likely aetiology in this case. Relevance and novel information Urethral diverticuli are a rare condition in veterinary medicine. To our knowledge, it has only been reported in two dogs and presumptively in one cat, all of which made a complete recovery after surgical intervention. The present case reports an unusual urethral deformity as a potential differential diagnosis for lower urinary tract signs in a young cat.

Retracted: Urethral diverticula in a 26‐year‐old gelding: A unique case report

“…The main hypothesis to explain the persistent dribbling of the urine is that, during voiding of the bladder, the diverticula fill up with urine and that there is a slow emptying caused by gravity afterwards. This was also suggested in the case report by Henry et al (2021) in a cat with urinary incontinence. The stagnation of the urine in the diverticula was also thought to have caused the urinary tract inflammation.…”

“…Voiding cystourethrogram is another described imaging modality with a reported sensitivity of 67%-95% (Crescenze & Goldman, 2015;Ockrim et al, 2009). This technique and retrograde contrast cystourethrogram were used successfully in small animals (Atilla, 2018;Foster et al, 1999;Henry et al, 2021;Watanabe et al, 2015). In this case, the use of a contrast cystourethrogram could have helped to determine the extent of the diverticula.…”

“…Surgical treatment was successfully performed in the four described cases in small animals (Atilla, 2018;Foster et al, 1999;Henry et al, 2021;Watanabe et al, 2015). Diverticulectomy has also been described to be successful in goats and calves (Abd-El-Hady, 2014;Bokhari, 2013;Doga, 2005;Maiti et al, 2018;Sylla et al, 2019).…”

“…Onethird of the cases have recurrent urinary tract infections (Davis & Robinson, 1970;Ganabathi et al, 1994). To our knowledge, only four cases have been described in small animals and clinical signs included: perineal swelling, dysuria, stranguria, urinary incontinence and urinary tract infections (Atilla, 2018;Foster et al, 1999;Henry et al, 2021;Watanabe et al, 2015). Distal/penile urethral diverticula have been reported in goat kids and calves and are frequently associated with hypospadias (Abd-El-Hady, 2014;Bokhari, 2013;Doga, 2005;Maiti et al, 2018;Simon et al, 2010;Sylla et al, 2019).…”

“…Diagnosis can be made in other species using cystourethroscopy, double-balloon positive pressure urethrography, voiding cystourethrogram, magnetic resonance imaging (MRI), computed tomography (CT) and transperineal and transvaginal ultrasound (Blander et al, 2001;Crescenze & Goldman, 2015;Dwarkasing et al, 2011;Gugliotta et al, 2015;Kim et al, 1993;Ljungqvist et al, 2007;Ockrim et al, 2009;Pathi et al, 2013;Romanzi et al, 2000;Stav et al, 2008). Various surgical techniques have been described in human medicine (Greiman et al, 2019) and successful surgical therapy has been reported in other species (Abd-El-Hady, 2014;Atilla, 2018;Bokhari, 2013;Foster et al, 1999;Henry et al, 2021;Maiti et al, 2018;Simon et al, 2010;Sylla et al, 2019;Doga, 2005;Watanabe et al, 2015). Conservative therapy has also been described (Ellik, 1957;Lee & Fynes, 2005;Mizrahi & Bitterman, 1988).…”