Initiation of Voiding in Healthy Women and those with Stress Incontinence

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Abstract
Healthy women (16) and 13 with stress incontinence were investigated by simultaneous urethroxystometry during the initiation of voiding. In the healthy women, there was a decrease in the maximum intra-urethral pressure immediately before micturition. A few seconds later (mean 3.0 s), the intravesical pressure increased. The urethral closure pressure decreased to zero, and urine started to escape from the urethra. In the patients with stress incontinence, 3 different ways of initiating micturition were observed. Five patients initiated voiding by the Valsalva maneuver, mainly by decreasing the maximum urethral pressure and mainly in the same way as the healthy women. Preoperative analysis of the micturition pattern by simultaneous urethrocystometry can be of value for the choice of operative procedure and thereby make it possible to avoid or reduce postoperative retention of urine.

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