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Neuromuscular urethral function and urethral urodynamic parameters between urgency and stress incontinence do not differ

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Abstract

Introduction and hypothesis

To describe and compare urethral neuromuscular function using concentric needle electromyography (CNEMG) and urodynamic (UDS) parameters between stress incontinent (SUI) and urge incontinent (UUI) women.

Methods

Incontinent women were recruited from a urogynecology clinic if they answered “sometimes” or “always” to one of the items on the Medical, Epidemiologic, and Social Aspects of Aging questionnaire. Participants were categorized by MESA scores into stress (SUI) or urgency (UUI) incontinence groups. Participants underwent CNEMG of the striated urethral sphincter at three insertion sites using Medtronic multiple motor unit action potential analysis. UDS was performed with Laborie microtip catheters: urethral pressure profiles were obtained at baseline and 300 ml. Data were analyzed in SPSS. Continuous variables were compared with independent t-test or Mann-Whitney U, categorical variables with chi-square test. A logistic regression was performed to control for variables found to be significant on univariate analysis.

Results

Fifty-six women (37 SUI, 19 UUI) with mean ± SD age of 53 ± 13 years participated. At baseline, patients with SUI were younger, more likely to be premenopausal and had lower BMIs. There were no differences in urethral EMG or UDS parameters between UUI and SUI women except lower maximum cystometric capacity in women with UUI. When controlling for age, BMI and MCC on logistic regression, there remained no differences between SUI and UUI groups on EMG or UDS parameters.

Conclusions

Women with UUI and DO show similar evidence of denervation-reinnervation injury to the striated urethral sphincter muscle as women with SUI.

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Funding

NIH K23 Award: K23 HD047325-01A1.

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Authors and Affiliations

  1. Northwestern University, 250 E Superior Street, Suite 5-2370, Chicago, IL, 60611, USA

    Julia Geynisman-Tan, Tsung Mou, Margaret G. Mueller & Kimberly Kenton

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  1. Julia Geynisman-Tan
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  2. Tsung Mou
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  3. Margaret G. Mueller
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  4. Kimberly Kenton
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Correspondence to Julia Geynisman-Tan.

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Conflict of interest

Drs. Geynisman-Tan and Mou have no conflicts of interest. Dr. Mueller: Expert Witness for Ethicon. Dr. Kenton: Expert Witness for Butler Snow/Ethicon; Consultant (past) for Boston Scientific.

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Conference Presentation

This manuscript has been presented as a full podium oral presentation at the American Urogynecologic Society virtual meeting in October 2020.

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Geynisman-Tan, J., Mou, T., Mueller, M.G. et al. Neuromuscular urethral function and urethral urodynamic parameters between urgency and stress incontinence do not differ. Int Urogynecol J 33, 871–876 (2022). https://doi.org/10.1007/s00192-021-04773-3

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  • DOI: https://doi.org/10.1007/s00192-021-04773-3

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