Posterior Pubo-urethral Ligaments in Normal and Genuine Stress Incontinent Women

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Abstract
Specimens of posterior pubo-urethral ligament were taken from 10 continent [human] females (7 at postmortem and 3 at gynecological surgery) and from 9 genuine stress incontinent patients. They were examined and compared using light microscopy, EM and neuro-histochemistry. Morphology of all specimens was similar: dense connective tissue elements enclosing smooth muscle bundles associated with numerous nerves, enzyme content and fine structure which were similar to those believed to represent cholinergic autonomic nerves. There was no difference in morphology, histochemistry and fine structure of specimens of the ligaments from control and incontinent patients. Altered morphology of posterior pubo-urethral ligaments is unlikely to be an etiological factor in genuine stress incontinence. Ligaments may play a role in stabilizing the proximal urethra or assist in bladder-neck opening during voiding.