Document Detail


Observations on the function of the female urethra: III: An overview with special reference to the relation between urethral hypermobility and urethral incompetence.
MedLine Citation:
PMID:  14694452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To analyze the relation between urethral hypermobility and urethral incompetence, and to summarize the interdependence between maximum urethral closure pressure (MUCP), urethral hypermobility, and urethral incompetence. PATIENTS AND METHODS: A group of 255 patients was selected from a large bank of cases. Inclusion criteria were age 20 years or above, no neurological disease, stable bladder, and no previous incontinence surgery or hysterectomy. The degree of hypermobility (cysto-urethrocele) and the degree of urethral incompetence (abdominal leak point pressure (ALPP)) were determined. Statistical analyses between urethral hypermobility and incompetence were performed with Spearman's correlation and the Jonckherre-Terpstra test. RESULTS: The Spearman's rank correlation test showed a statistically significant relation between urethral hypermobility and the degree of urethral incompetence (P = 0.0049). CONCLUSIONS: The statistically significant relation between urethral incompetence and hypermobility suggests that urethral incompetence will increase as the degree of urethral hypermobility does. Optimal conditions for urinary continence include a high maximum urethral closure pressure, absence of hypermobility, and a low degree of urethral incompetence. This last factor is assured by a strong support underneath the urethra permitting compression of the latter during straining. Failure of the urethral closure mechanism is highly probable with a diminished maximum closure pressure accompanied by urethral hypermobility often associated with a high degree of urethral incompetence. Clinically significant urinary incontinence may appear in many intermediate circumstances between these two extreme states, but stress urinary incontinence is essentially an activity-related phenomenon.
Authors:
Erik Schick; Martine Jolivet-Tremblay; Jocelyne Tessier; Charles Dupont; Pierre E Bertrand
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurourology and urodynamics     Volume:  23     ISSN:  0733-2467     ISO Abbreviation:  Neurourol. Urodyn.     Publication Date:  2004  
Date Detail:
Created Date:  2003-12-24     Completed Date:  2004-04-21     Revised Date:  2006-07-17    
Medline Journal Info:
Nlm Unique ID:  8303326     Medline TA:  Neurourol Urodyn     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-6     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley-Liss, Inc.
Affiliation:
Division of Urology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Québec, Canada. eschick@videotron.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Middle Aged
Muscle Hypertonia / complications*,  physiopathology
Pressure
Urethra / physiopathology*
Urethral Diseases / complications*,  physiopathology
Urinary Incontinence, Stress / complications*,  physiopathology
Urodynamics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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