| Urethral sphincter morphology and function with and without stress incontinence. | |
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MedLine Citation:
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PMID: 19450822 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Daniel M Morgan; Wolfgang Umek; Kenneth Guire; Helen K Morgan; Alice Garabrant; John O L DeLancey |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2009-05-17 |
Journal Detail:
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Title: The Journal of urology Volume: 182 ISSN: 1527-3792 ISO Abbreviation: J. Urol. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-12 Completed Date: 2010-07-01 Revised Date: 2011-03-23 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 203-9 Citation Subset: AIM; IM |
Affiliation:
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University of Michigan, Ann Arbor, Michigan, USA. morgand@umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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