Urethral Closure Mechanism under Stress Conditions

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Abstract
During a rise in intraabdominal pressure, even under stress conditions, continence is sustained by simultaneous pressure transmission to the urethra. In 231 continent patients, pressure transmission on the urethral profile (functional urethra) was studied measuring intraurethral pressure changes. It became evident that there was a continuous decrease along the proximal third of the functional urethra; however, at the zone of maximal urethral closure pressure (pelvic floor), a significant rise in pressure transmission was observed. On the contrary, in 177 patients with stress-incontinence, this pressure rise (reflex contraction of the pelvic floor) could not be found. This ‘reflex pressure’ parameter may add important information for the evaluation of urethral closure under stress conditions.

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