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Influence of pelvic floor muscle contraction on the profile of vaginal closure pressure in continent and stress urinary incontinent women.
J Urol. 2008 May; 179(5):1917-22.JU

Abstract

PURPOSE

We characterized the vaginal pressure profile as a representation of closure forces along the length and circumference of the vaginal wall. Vaginal pressure profile data were used to test the hypothesis that the strength of pelvic floor muscle contractions differs significantly between continent women and women with stress urinary incontinence.

MATERIALS AND METHODS

Vaginal pressure profile recordings were made in 23 continent subjects and in 10 patients with stress urinary incontinence. The recordings characterized closure forces along the entire length of the vagina and identified differences among the anterior, posterior, left and right sides of the vaginal wall. Using a novel, directionally sensitive vaginal probe we made vaginal pressure profile measurements with the women at rest and during pelvic floor muscle contraction while supine.

RESULTS

The nature of the vaginal pressure profile was characterized in terms of force distribution in the anterior and posterior vaginal walls, which was significantly greater than that on the left and right sides. The continent group had significant greater maximum pressure than the stress urinary incontinence group on the posterior side at rest (mean +/- SE 3.4 +/- 0.3 vs 2.01 +/- 0.36 N/cm(2)) and during pelvic floor muscle contraction (4.18 +/- 0.26 vs 2.25 +/- 0.41 N/cm(2)). The activity pressure difference between the posterior and anterior vaginal walls in the continent group was significantly increased when the pelvic floor muscles contracted vs that at rest (3.29 +/- 0.21 vs 2.45 +/- 0.26 N/cm(2)). However, the change observed in the stress urinary incontinence group was not significant (1.85 +/- 0.38 vs 1.35 +/- 0.27 N/cm(2)).

CONCLUSIONS

The results demonstrate that the voluntary pelvic floor muscles impose significant closure forces along the vaginal wall of continent women but not in women with stress urinary incontinence. The implication of these findings is that extrinsic urethral closure pressure is insufficiently augmented by pelvic floor muscle contraction in women with stress urinary incontinence.

Authors+Show Affiliations

Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18353401

Citation

Shishido, Keiichi, et al. "Influence of Pelvic Floor Muscle Contraction On the Profile of Vaginal Closure Pressure in Continent and Stress Urinary Incontinent Women." The Journal of Urology, vol. 179, no. 5, 2008, pp. 1917-22.
Shishido K, Peng Q, Jones R, et al. Influence of pelvic floor muscle contraction on the profile of vaginal closure pressure in continent and stress urinary incontinent women. J Urol. 2008;179(5):1917-22.
Shishido, K., Peng, Q., Jones, R., Omata, S., & Constantinou, C. E. (2008). Influence of pelvic floor muscle contraction on the profile of vaginal closure pressure in continent and stress urinary incontinent women. The Journal of Urology, 179(5), 1917-22. https://doi.org/10.1016/j.juro.2008.01.020
Shishido K, et al. Influence of Pelvic Floor Muscle Contraction On the Profile of Vaginal Closure Pressure in Continent and Stress Urinary Incontinent Women. J Urol. 2008;179(5):1917-22. PubMed PMID: 18353401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of pelvic floor muscle contraction on the profile of vaginal closure pressure in continent and stress urinary incontinent women. AU - Shishido,Keiichi, AU - Peng,Qiyu, AU - Jones,Ruth, AU - Omata,Sadao, AU - Constantinou,Christos E, Y1 - 2008/03/18/ PY - 2007/08/30/received PY - 2008/3/21/pubmed PY - 2008/5/21/medline PY - 2008/3/21/entrez SP - 1917 EP - 22 JF - The Journal of urology JO - J Urol VL - 179 IS - 5 N2 - PURPOSE: We characterized the vaginal pressure profile as a representation of closure forces along the length and circumference of the vaginal wall. Vaginal pressure profile data were used to test the hypothesis that the strength of pelvic floor muscle contractions differs significantly between continent women and women with stress urinary incontinence. MATERIALS AND METHODS: Vaginal pressure profile recordings were made in 23 continent subjects and in 10 patients with stress urinary incontinence. The recordings characterized closure forces along the entire length of the vagina and identified differences among the anterior, posterior, left and right sides of the vaginal wall. Using a novel, directionally sensitive vaginal probe we made vaginal pressure profile measurements with the women at rest and during pelvic floor muscle contraction while supine. RESULTS: The nature of the vaginal pressure profile was characterized in terms of force distribution in the anterior and posterior vaginal walls, which was significantly greater than that on the left and right sides. The continent group had significant greater maximum pressure than the stress urinary incontinence group on the posterior side at rest (mean +/- SE 3.4 +/- 0.3 vs 2.01 +/- 0.36 N/cm(2)) and during pelvic floor muscle contraction (4.18 +/- 0.26 vs 2.25 +/- 0.41 N/cm(2)). The activity pressure difference between the posterior and anterior vaginal walls in the continent group was significantly increased when the pelvic floor muscles contracted vs that at rest (3.29 +/- 0.21 vs 2.45 +/- 0.26 N/cm(2)). However, the change observed in the stress urinary incontinence group was not significant (1.85 +/- 0.38 vs 1.35 +/- 0.27 N/cm(2)). CONCLUSIONS: The results demonstrate that the voluntary pelvic floor muscles impose significant closure forces along the vaginal wall of continent women but not in women with stress urinary incontinence. The implication of these findings is that extrinsic urethral closure pressure is insufficiently augmented by pelvic floor muscle contraction in women with stress urinary incontinence. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/18353401/Influence_of_pelvic_floor_muscle_contraction_on_the_profile_of_vaginal_closure_pressure_in_continent_and_stress_urinary_incontinent_women_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2008.01.020?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -