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Decrease in urethral pressure following repeated cough efforts: A new concept for pathophysiology of stress urinary incontinence
Author(s) -
Deffieux Xavier,
Hubeaux Katelyne,
Porcher Raphaël,
Ismael Samer Sheikh,
Raibaut Patrick,
Amarenco Gérard
Publication year - 2007
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2007.01887.x
Subject(s) - medicine , urinary incontinence , intraclass correlation , stress incontinence , urology , anesthesia , surgery , psychometrics , clinical psychology
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.

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