Urethral pressure variations in women with neurourological symptoms: I. Relationship to urethral and pelvic floor striated muscle

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AbstractSimultaneous urethrocystometry and electromyography (EMG) of the urethral and pelvic floor striated muscle were performed in 42 gynecological patients with neurourological symptoms. Their maximum urethral pressure varied between 20 and 124 cm H2O. A correlation analysis was performed between the maximum urethral pressure and the integrated EMG of the urethral striated muscle and the pelvic floor striated muscle. The analyses were performed on results obtained in 1‐min periods during bladder filling before first desire to void was reported, when first desire to void was reported, and when a strong desire to void was reported.In 21 patients no correlation was found between the urethral and pelvic floor striated muscle activity and the maximum urethral pressure at any stage of bladder filling. In the other 21 patients a correlation was found in at least 1 of the 3 stages. At all stages of bladder filling a correlation was found significantly more often between the maximum urethral pressure and the striated urethral muscle EMG than between the maximum urethral pressure and the striated pelvic floor muscle EMG. Thus, activity of the urethral striated muscle cannot be reliably studied in an EMG recording from the pelvic floor striated muscle. In the same patient, periods with a correlation could be succeeded by periods without a correlation. Thus, the urethral pressure variations may in the same patient sometimes be caused mainly by the urethral striated muscle and sometimes mainly by the urethral smooth muscle.