Simultaneous intraurethral and intravesical pressure studies in normal women and those with stress incontinence

Abstract

M A N Y theories regarding normal urinary contineke and the development of stress incontinence in women have been advanced. Llntil quite recently normal urinary continence and micturition were thought to involve little more than an appropriate interaction of the bladder detrusor and urethral sphincter muscles.“’ Some gynecologists ha1.e tried to esplain the reason for urinary stress incontinence in equally simple terms based upon empiric observations such as the “short urethra”” or tht “inadequate posterior urethro\xxical angle.“” JeffcoatcaT and I>uttong have cmphasiztd that the inadequate posterior urcthrovcsical angle is a frequent accompanying sign of. not the reason for. stress incontincncc. However the sign is often misinterpreted as the cause of stress incontinence. It is now realized that normal urinary continence inl,olves a complicated mechanism. The functional result of this mechanism is that, in maintaining continence. the intraurethral pressure remains Kreater than the intravesical pressure. EnhGrning” has shown that in normal women and those with stress incontincncc at rest the intraurcthral pres-