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  • Title: Decrease in urethral pressure following repeated cough efforts: a new concept for pathophysiology of stress urinary incontinence.
    Author: Deffieux X, Hubeaux K, Porcher R, Ismael SS, Raibaut P, Amarenco G.
    Journal: Int J Urol; 2007 Nov; 14(11):1019-24. PubMed ID: 17956530.
    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.
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