Document Detail


Urethral sphincter morphology and function with and without stress incontinence.
MedLine Citation:
PMID:  19450822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Using magnetic resonance images we analyzed the relationship between urethral sphincter anatomy, urethral function and pelvic floor function.
MATERIALS AND METHODS: A total of 103 women with stress incontinence and 108 asymptomatic continent controls underwent urethral profilometry, urethral axis measurement with a cotton swab, vaginal closure force measurement with an instrumented speculum and magnetic resonance imaging. Striated urogenital sphincter length was determined and its thickness was measured in the proximal sphincter, where its circular shape enables estimation of striated urogenital sphincter area. A length-area index was calculated as a proxy for volume.
RESULTS: The striated urogenital sphincter in women with stress incontinence was 12.5% smaller than that in asymptomatic continent women (mean +/- SD length-area index 766.4 +/- 294.3 vs 876.2 +/- 407.3 mm(3), p = 0.04). The groups did not differ significantly in striated urogenital sphincter length (13.2 +/- 3.4 vs 13.7 +/- 3.9 mm, p = 0.40), thickness (2.83 +/- 0.8 vs 3.11 +/- 1.4 mm, p = 0.09) or area (59.1 +/- 18.4 vs 62.9 +/- 24.7 mm(2), p = 0.24). Striated urogenital sphincter length and area, and the length-area index were associated during voluntary pelvic muscle contraction with more urethral axis elevation and increased vaginal closure force augmentation.
CONCLUSIONS: A smaller striated urogenital sphincter is associated with stress incontinence and poorer pelvic floor muscle function.
Authors:
Daniel M Morgan; Wolfgang Umek; Kenneth Guire; Helen K Morgan; Alice Garabrant; John O L DeLancey
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2009-05-17
Journal Detail:
Title:  The Journal of urology     Volume:  182     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-12     Completed Date:  2010-07-01     Revised Date:  2011-03-23    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-9     Citation Subset:  AIM; IM    
Affiliation:
University of Michigan, Ann Arbor, Michigan, USA. morgand@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Case-Control Studies
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Muscle Contraction / physiology*
Pelvic Floor / pathology,  physiopathology
Prognosis
Reference Values
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Urethra / pathology*,  physiopathology*
Urinary Incontinence, Stress / diagnosis*,  etiology
Urodynamics
Grant Support
ID/Acronym/Agency:
P50 HD 044406/HD/NICHD NIH HHS; P50 HD044406-05/HD/NICHD NIH HHS
Comments/Corrections

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


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