Decrease in urethral pressure following repeated cough efforts: a new concept for pathophysiology of stress urinary incontinence

Int J Urol. 2007 Nov;14(11):1019-24. doi: 10.1111/j.1442-2042.2007.01887.x.

Abstract

Aims: To describe the decrease in maximum urethral closure pressure (MUCP) following repeated coughs in women with stress urinary incontinence (SUI).

Methods: MUCP was recorded at rest and after seven cough efforts in 70 women under age 40 referred for urodynamic investigation (47 women with SUI and 23 women without SUI).

Results: The intraclass correlation coefficient for repeatability was very good at 400 mL filling volume: 0.94 (95%CI: 0.85-0.98), as compared to the mean and standard-deviations of the MUCP measurements. A decrease in MUCP >20% after seven cough efforts was observed in 18(38%) patients in the SUI group and in just 1(4%) woman in the non-SUI group (P = 0.0069).

Conclusions: Many women with SUI exhibit a sharp decrease in MUCP after repeated coughs. Many hypotheses may explain this phenomenon, including increased fatigue of the periurethral muscles.

MeSH terms

  • Adult
  • Cough*
  • Fatigue / physiopathology
  • Female
  • Humans
  • Manometry
  • Pressure
  • Prospective Studies
  • Reproducibility of Results
  • Retrospective Studies
  • Urethra / physiopathology*
  • Urinary Catheterization
  • Urinary Incontinence, Stress / physiopathology*
  • Urodynamics / physiology