Materials and Methods
Case selection—Medical records of dogs admitted to the Clinique vétérinaire Alliance for surgical treatment of perineal hernia between November 2002 and November 2009 were reviewed. Additional follow-up data were obtained via communications with referring veterinarians and clients. Dogs were included in the study when the position of the urinary bladder at the time of surgery was recorded in the medical records, the dogs had been treated with IOMT, and the dogs’ conditions had been followed up for at least 6 months. Dogs were divided into a UBR group and a no-UBR group.
Medical records review—Dog signalment, primary clinical signs, duration of clinical signs, physical examination findings, results of abdominal ultrasonography, surgical techniques used, intraoperative complications, duration of hospital stay, postoperative complications, outcome, and cause of death were collected from the medical records. Perineal hernia had been diagnosed on the basis of medical history, physical examination, and rectal examination findings. Surgical techniques used were classified as IOMT only or as LapIOMT when a cystopexy or a colopexy was performed with a laparotomy before IOMT. Urinary incontinence was defined as involuntary dribbling of urine. Fecal incontinence was defined as involuntary fecal losses. Tenesmus was defined as persistent or prolonged straining or painful defecation. Recurrence was defined as the development of obvious perineal swelling or loss of support of the rectal wall on a side on which surgery had been performed, as detected via rectal examination. Follow-up interval was defined as the interval between surgery and the last entry in the medical record at the Clinique vétérinaire Alliance or the last contact with the owner or referring veterinarian.
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Statistical analysis—Descriptive statistics were calculated, with median and range reported. The Wilcoxon rank sum test was performed to compare age, body weight, duration of clinical signs before surgery, duration of hospital stay, and follow-up time between the no-UBR and UBR groups and between IOMT and LapIOMT groups. The Fisher exact test was used to compare the incidence of unilateral and bilateral perineal hernia and postoperative complications between groups. Kaplan-Meier survival analysis was used to determine the DFI. The log-rank test was used to compare median DFI between groups. A dog was classified as disease free when clinical signs related to perineal hernia were absent > 1 month after surgery. At the time of final follow-up (median, 53 months), dogs were censored when they were free from clinical signs at the time of final follow-up, died of causes unrelated to perineal hernia, or were lost to follow-up. All analyses were performed with a commercially available software package.b Values of P < 0.05 were considered significant.
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