Stress incontinence investigated with urodynamics 30 years ago

Abstract

An article published in 1961 is reviewed. It reported on the simultaneously measured pressures in the urethra and bladder of both healthy women and women afflicted by stress incontinence. It was found that the difference between the two pressures was crucial for the preservation of continence. If pressure in one section of the urethra was higher than in the bladder, urine could not enter that section and closure was maintained. In patients with stress incontinence it was noted that when the difference in pressure, closure pressure, was lowered to zero during coughing, leakage would be noted. This was due to low urethral muscle tone causing a low resting closure pressure, as well as to an incomplete transmittance of abdominal pressure to the upper urethra. An operation for stress incontinence causes the upper urethra to be more fully exposed to increases in intra-abdominal pressure, so that physical activity has less effect on closure pressure.