TY - JOUR
T1 - Urethral sphincter morphology in women with detrusor instability
AU - Major, Heather
AU - Culligan, Patrick
AU - Heit, Michael
PY - 2002
Y1 - 2002
N2 - OBJECTIVE: To determine whether sonographic urethral sphincter morphology is different in patients with detrusor instability than in those with normal urodynamic testing. METHODS: Patients from a population of women presenting for evaluation of urinary incontinence or pelvic organ prolapse underwent intraurethral ultrasonography before multichannel urodynamic testing. Maximal rhabdosphincter thickness, total urethral diameter, total urethral circumference, and longitudinal smooth muscle thickness, diameter, and circumference were measured. For patients with detrusor instability, the strength of the involuntary detrusor contraction and the bladder volume at its onset were recorded. These data were compared with information from history questionnaires and urodynamic evaluations. RESULTS: The 17 patients with detrusor instability and 16 patients with normal urodynamic testing did not differ with respect to age, vaginal parity, race, weight, body mass index, prior continence surgery, or maximal total urethral closure pressure. Patients with detrusor instability, had decreased urethral longitudinal smooth muscle thickness (3.0 ± 0.9 mm vs 4.1 ± 0.7 mm, P = .001), total urethral diameter (18.0 ± 1.6 mm vs 19.4 ± 1.4 mm, P = .01), and total urethral circumference (5.65 ± 0.5 cm vs 6.1 ± 0.4 cm, P = .012) compared with those with normal urodynamic tests. A linear relationship between rhabdosphincter thickness and strength of involuntary detrusor contraction was observed (r = .686, P = .002). CONCLUSION: Urethral sphincter morphology is different in patients with detrusor instability compared with those who have normal urodynamic tests. These findings provide an anatomic basis for the physiologic findings in patients with "urethrogenic" detrusor instability.
AB - OBJECTIVE: To determine whether sonographic urethral sphincter morphology is different in patients with detrusor instability than in those with normal urodynamic testing. METHODS: Patients from a population of women presenting for evaluation of urinary incontinence or pelvic organ prolapse underwent intraurethral ultrasonography before multichannel urodynamic testing. Maximal rhabdosphincter thickness, total urethral diameter, total urethral circumference, and longitudinal smooth muscle thickness, diameter, and circumference were measured. For patients with detrusor instability, the strength of the involuntary detrusor contraction and the bladder volume at its onset were recorded. These data were compared with information from history questionnaires and urodynamic evaluations. RESULTS: The 17 patients with detrusor instability and 16 patients with normal urodynamic testing did not differ with respect to age, vaginal parity, race, weight, body mass index, prior continence surgery, or maximal total urethral closure pressure. Patients with detrusor instability, had decreased urethral longitudinal smooth muscle thickness (3.0 ± 0.9 mm vs 4.1 ± 0.7 mm, P = .001), total urethral diameter (18.0 ± 1.6 mm vs 19.4 ± 1.4 mm, P = .01), and total urethral circumference (5.65 ± 0.5 cm vs 6.1 ± 0.4 cm, P = .012) compared with those with normal urodynamic tests. A linear relationship between rhabdosphincter thickness and strength of involuntary detrusor contraction was observed (r = .686, P = .002). CONCLUSION: Urethral sphincter morphology is different in patients with detrusor instability compared with those who have normal urodynamic tests. These findings provide an anatomic basis for the physiologic findings in patients with "urethrogenic" detrusor instability.
UR - http://www.scopus.com/inward/record.url?scp=0036145361&partnerID=8YFLogxK
U2 - 10.1016/S0029-7844(01)01655-6
DO - 10.1016/S0029-7844(01)01655-6
M3 - Article
C2 - 11777512
AN - SCOPUS:0036145361
SN - 0029-7844
VL - 99
SP - 63
EP - 68
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 1
ER -