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Effects of voluntary pelvic floor contraction and relaxation on the urethral closure pressure

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Abstract

The aim of this study was to assess the effects of voluntary pelvic floor contraction and voluntary pelvic floor relaxation on the urethral closure pressure at rest. In 104 consecutive women, three urethral pressure profiles were performed: standard profile at rest, with voluntary pelvic floor contraction and with voluntary pelvic floor relaxation. A low-pressure urethra was defined as a maximum urethral closure pressure of ≤20 cmH2O. The age ranged between 24 and 82 years. The maximum urethral closure pressure at rest was significantly augmented during pelvic floor contraction (mean: 18 cmH2O). Compared with the first profile, it decreased significantly with pelvic floor relaxation (mean decrement: 8 cmH2O). A low-pressure urethra was detected in 5 women during the first profile and in a further 11 during pelvic floor relaxation. Because of the significant influence of pelvic floor activity on the urethral closure pressure at rest, the scientific and clinical credibility of urethral pressure measurements remain questionable.

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Acknowledgement

We thank the urodynamic nurses Irene Hauser and Elsbeth Ludwig for their substantial help in conducting this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Cantonal Hospital Lucerne, 6000, Lucerne 16, Switzerland

    Kaven Baessler, Kirstin Miska, Ruth Draths & Bernhard Schuessler

  2. Level 4, Suite 86, Sandford Jackson Building, 30 Chasely Street, QLD 4066, Auchenflower, Australia

    Kaven Baessler

Authors
  1. Kaven Baessler
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  2. Kirstin Miska
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  3. Ruth Draths
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  4. Bernhard Schuessler
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Corresponding author

Correspondence to Kaven Baessler.

Additional information

Part of the results were presented at the Annual Meeting of the International Continence Society (ICS) 1999 in Denver and at national German and Swiss gynecology meetings

Editorial Comment: This very interesting study on the influence of the pelvic floor muscles on urethral pressure gives basic information about the functionality of the urethra. There is still a great lack of knowledge as we really do not know “what exactly we measure” when we perform an urethral pressure profile. The study points out that further investigations are necessary that should focus on the different parts of the pelvic floor muscles and their influence on the continence mechanisms. New investigative options such as magnetic nuclear resonance (MNR) and perineal ultrasound should be involved. It would have been even more interesting if the results of the performed perineal ultrasound would have been described beside the palpation of the muscle strength

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Baessler, K., Miska, K., Draths, R. et al. Effects of voluntary pelvic floor contraction and relaxation on the urethral closure pressure. Int Urogynecol J 16, 187–191 (2005). https://doi.org/10.1007/s00192-004-1232-y

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  • DOI: https://doi.org/10.1007/s00192-004-1232-y

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