Pressure transmission to the pre-urethral space in stress incontinence.
Pressure transmission from the abdomen to the pre-urethral space has been studied in stress- incontinent women and in some women following pubococcygeal repair for stress incontinence. Pressure was recorded at different levels of the pre-urethral space and simultaneously in the bladder. Simultaneous measurements inside and outside the urethra at different levels above the external urethral meatus showed that an intra-abdominal pressure rise was transmitted via the pre-urethral space to the urethra. Pressure was transmitted almost in full to the surroundings of the lower-most part of the bladder, but outside the functional urethra, transmission was successively more defective along the urethra towards the external meatus. Therefore, a short functional length and a distal maximal pressure plateau in the urethra, as in stress incontinence, is a disadvantage. Pressure losses amount to 1/3 or more. Pressure transmission could be improved to "supranormal" values by establishing firm support for the urethra, thereby allowing a minimum of rotational descent with stress and providing good counterpressure.
D005260:Female; D006801:Humans; D006874:Hydrostatic Pressure; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D011312:Pressure; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000601:surgery