title: Decrease in urethral pressure following repeated cough efforts: a new concept for pathophysiology of stress urinary incontinence.
abstract: OBJECTIVE
  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.
authors.affiliation: Pierre & Marie Curie University; Urodynamics Laboratory, Rothschild Hospital, AP-HOP, 33 boulevard de Picpus, Paris Cedex 12, France. x.deffieux@free.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Deffieux
authors.forename: Katelyne
authors.initials: K
authors.lastname: Hubeaux
authors.forename: Raphaël
authors.initials: R
authors.lastname: Porcher
authors.forename: Samer Sheikh
authors.initials: SS
authors.lastname: Ismael
authors.forename: Patrick
authors.initials: P
authors.lastname: Raibaut
authors.forename: Gérard
authors.initials: G
authors.lastname: Amarenco
mesh_terms: D000328:Adult; D003371:Cough; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D006801:Humans; D008365:Manometry; D011312:Pressure; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014521:Urethra / Q000503:physiopathology*; D014546:Urinary Catheterization; D014550:Urinary Incontinence, Stress / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology