Submucosal urethral bulking with 2.5% polyacrylamide hydrogel (Mictamid) for urinary incontinence in male dogs using a percutaneous fluoroscopically assisted perineal approach.

Percutaneous fluoroscopic PAHG urethral bulking is a promising, safe option for urinary incontinence in male dogs.

This retrospective case series describes a novel percutaneous fluoroscopically assisted perineal approach for submucosal urethral bulking with 2.5% polyacrylamide hydrogel (PAHG; Mictamid) in five male dogs with urinary incontinence, most suspected to have urethral sphincter mechanism incompetence (USMI). One dog also presented with a concurrent urethral diverticulum. The percutaneous perineal approach was developed to overcome the anatomical challenges of accessing the male canine urethra cystoscopically for injection purposes. Continence was evaluated using a 1–5 scoring system (1 = constant incontinence; 5 = fully continent) at baseline, 30 days post-procedure, and at last follow-up. Median baseline continence score was 2 (range 2–4). Following treatment, scores improved significantly at both 30 days (median 5; range 4–5) and at last follow-up (median 5; range 4–5; P = .03), with a median follow-up period of 108 days (range 51–154 days). All five dogs demonstrated clinical improvement in continence. The only complication recorded was self-limiting hematuria in one dog, and no severe adverse events were observed. These findings suggest that percutaneous fluoroscopically assisted perineal urethral bulking with PAHG is a feasible, minimally invasive, and well-tolerated treatment option for urinary incontinence in male dogs, offering a promising alternative in a population for which therapeutic options remain limited. Larger prospective studies with longer follow-up periods are needed to further validate efficacy and durability.

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