Skip to main content
SpringerLink
Log in

The value of the urethral pressure profile

  • Chapter
Practical Aspects of Urinary Incontinence

Part of the book series: Developments in Surgery ((DISU,volume 7))

Abstract

The term ‘urethral pressure profile’ (UPP) denotes a recording of the intraluminal pressure exerted by the urethral wall on a pressure measuring device as it is withdrawn from the bladder to the external meatus with the bladder at rest. Under normal conditions, during the filling phase of the bladder, the urethral lumen is closed and continence is maintained at the level of the bladder neck [1–5]. The intraluminal pressure within the urethra exceeds the bladder pressure over almost the entire urethral length [6].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ardran G.M., Simmons C.A. and Stewart J.H. The closure of the female urethra. J. Obst. and Gynaec. Brit. Emp. 63 (1956): 26.

    Article  CAS  Google Scholar 

  2. Caine M. and Edwards D. Peripheral control of micturition; a cineradiographic study. Brit. J. Urol., 30 (1958): 34.

    Article  CAS  Google Scholar 

  3. Low, J.A. Role of the normal female urethra in the sphincter mechanism of the bladder. Am. J. Obstet. Gynecol. 82 (1961): 1.

    PubMed  CAS  Google Scholar 

  4. Jeffcoate T.N.A. The principles governing the treatment of stress incontinence of urine in the female. Brit. J. Urol. 37 (1965): 633.

    Article  PubMed  CAS  Google Scholar 

  5. Turner-Warwick R. The treatment of female urinary incontinence. Proc. VI Annual Meeting I.C.S. Antwerp (1976).

    Google Scholar 

  6. Enhörning G., Miller E.R. and Hinman F. Urethral closure studied with cineroentgenography and simultaneous bladder-urethra pressure recording. Surg. Gynecol. & Obstet. 118 (1964): 507.

    Google Scholar 

  7. Lapides J., Ajemian E.P., Breakey B.A. and Lichtwardt J.R. Further observations on the kinetics of the urethrovesical sphincter. J. Urol. 84 (1960): 86.

    PubMed  CAS  Google Scholar 

  8. Brown M. and Wickham J.E.A. The urethral pressure profile. Brit. J. Urol. 41 (1969): 211.

    Article  PubMed  CAS  Google Scholar 

  9. Robertson J.R. Gas cystometrogram with urethral pressure profile. Obst. Gynec. 44 (1974): 72.

    CAS  Google Scholar 

  10. Raz S. and Kaufman J.J. Carbondioxide urethral pressure profile. J. Urol. 115 (1976): 439.

    PubMed  CAS  Google Scholar 

  11. Simons I. Studies in bladder function. The sphincterometer. J. Urol. 35 (1936): 96.

    Google Scholar 

  12. Hodgkinson C.P. Direct urethrocystometry. Am. J. Obstet. Gynecol. 79 (1960): 664.

    Google Scholar 

  13. Enhörning, G. Simultaneous recording of intravesical and intraurethral pressure. Acta Chir. Scand. Suppl. 276 (1961).

    Google Scholar 

  14. Donker P. J., Ivanovici F. and Noach E.L. Analysis of the urethral pressure profile by means of electromyography and the administration of drugs. Brit. J. Urol. 44 (1972): 180.

    Article  PubMed  CAS  Google Scholar 

  15. Tanagho E.A. and Jonas U. Membrane catheter: effective for recording pressures in the lower urinary tract. Urology 10 (1977): 173.

    Article  PubMed  CAS  Google Scholar 

  16. Karlsson S. Experimental studies of the functioning of the female urinary bladder and urethra. Acta Obstet. Gynec. Scand. 32 (1953): 285.

    Article  Google Scholar 

  17. Shelley T. and Warrell D.W. Measurement of intravesical and intraurethral pressure in normal women suffering from incontinence of urine. J. Obstet. Gynecol. Br. Commonw. 72 (1965): 926.

    Article  Google Scholar 

  18. Asmussen M. and Ulmsten U. Simultaneous urethrocystometry and urethra pressure profile measurements with a new technique. Acta Obstet. Gynec. Scand. 54 (1975): 1.

    Google Scholar 

  19. Abrams P.H., Martin S. and Griffith D.J. The measurement and interpretation of urethral pressures obtained by the method of Brown and Wickham. Brit. J. Urol. 50 (1978): 33.

    Article  PubMed  CAS  Google Scholar 

  20. Millar H.D. and Baker L.E. Stable ultraminiature catheter tip pressure transducer. Med. Biol. Eng. 11 (1973): 86.

    Article  PubMed  CAS  Google Scholar 

  21. Asmussen M. Urethrocystometry in women. Thesis, Lund, Studentlitteratuur (1975).

    Google Scholar 

  22. Furrer M. and Eberhard J. Vergleichende Untersuchungen zwischen der Zystourethromanometrie nach Heidenreich und der Mikrotransducer methode nach Ulmsten. Gynäk. Rdsch. 17 Suppl. 1 (1977): 105.

    Google Scholar 

  23. Erlandson B.E. and Fall M. Urethral pressure profile studied by two different microtip transducers and an open catheter system. Urol. Int. 33 (1978): 79.

    Article  Google Scholar 

  24. Teague C.T. and Merrill D.C. Laboratory comparison of urethral Profilometry techniques. Urology 13 (1979): 221.

    Article  PubMed  CAS  Google Scholar 

  25. Bates P., Bradley W.E. and Hald, T. et al. First and second reports on the standardization of terminology of lower urinary tract function. Urology 9 (1977): 237.

    Article  Google Scholar 

  26. Zinner N.R., Ritter R.C. and Sterling A.M. The mechanism of micturition. From: ‘Scientific foundations of urology’, Vol. II: 39. Eds.: D.I. Williams and G.D. Chisholm. William Heinemann. Medical books, Ltd. London (1976).

    Google Scholar 

  27. von Hayek H. Die Weibliche Harnröhre. Handbuch der Urologie II. Anatomie und Embryologie I, 315 (1969).

    Google Scholar 

  28. Zinner N.R., Sterling A.M. and Ritter R.C. Role of inner urethral softness in urinary continence. Urology 16 (1980): 115.

    Article  PubMed  CAS  Google Scholar 

  29. Huisman A.B. Morfologie van de vrouwelijke urethra. Thesis, Groningen, The Netherlands (1979).

    Google Scholar 

  30. Smith P.Ch.M. Age changes in the female urethra. Brit. J. Urol. 44 (1972): 667.

    Article  PubMed  CAS  Google Scholar 

  31. Berkow S.G. The corpus spongeosum of the urethra: its possible role in urinary control and stress incontinence in women. Am. J. Obstet. Gynecol. 65 (1953): 346.

    PubMed  CAS  Google Scholar 

  32. Huisman A.B. and Salomé A.J. Morphology of the female urethra in relation to age. Proc. VII Annual Meeting I.C.S. Portoroz. P. 123 (1977).

    Google Scholar 

  33. Raz S., Caine M. and Zeigler M. The vascular component in the production of intraurethral pressure. J. Urol. 108 (1972): 93.

    PubMed  CAS  Google Scholar 

  34. Rud T., Andersson K.E., Asmussen M., Hunting A. and Ulmsten U. Factors maintaining the intraurethral pressure in women. Invest. Urol. 17 (1980): 343.

    PubMed  CAS  Google Scholar 

  35. Tulloch A.G.S. The vascular contribution to intra-urethral pressure. Brit. J. Urol. 46 (1974): 659.

    Article  PubMed  CAS  Google Scholar 

  36. Molnar G. and Nagy T. Die Bedeutung der Gefässverhältnisse der Weiblichen Harnröhre für die Funktion des Verschluss-systems der Harnblase. Z.f. Urol. 58 (1965): 825.

    CAS  Google Scholar 

  37. Van Geelen J.M., Doesburg W.H., Thomas C.M.G. and Martin Jr. C.B. Urodynamic studies in the normal menstrual cycle: The relationship between hormonal changes during the menstrual cycle and the urethral pressure profile. Am. J. Obstet. Gynecol., 141 (1981): 384.

    PubMed  Google Scholar 

  38. Woodburne R.T. The sphincter mechanism of the urinary bladder and the urethra. Anat. Rec. 141 (1961): 11.

    Article  PubMed  CAS  Google Scholar 

  39. Bro-Rasmussen F., Halborg Sørensen H., Bredahl E. and Kelstrup A. The structure and function of the urinary bladder. Urol. Int. 19 (1965): 280.

    Article  PubMed  CAS  Google Scholar 

  40. Donker P.J., Dröes J.Th.P.M. and van Ulden B.M. Anatomy of the musculature and innervation of the bladder and the urethra. In: Williams D.I. and Chisholm G.D. (eds.) Scientific Foundations of Urology, Vol. II: 21. William Heinemann Medical Books, Ltd., London (1976).

    Google Scholar 

  41. Hutch J.A. Anatomy and physiology of the bladder, trigone and urethra. Butterworths Appleton Century Crofts, London (1972).

    Google Scholar 

  42. Tanagho E.A., Meyers F.H. and Smith D.R. Urethral resistance: its components and implications. I. Smooth muscle components. Invest. Urol. 7 (1969): 136.

    CAS  Google Scholar 

  43. Awad S.A. and Downie J.W. Relative contributions of smooth and striated muscles to the canine urethral pressure profile. Brit. J. Urol. 48 (1976): 347.

    Article  CAS  Google Scholar 

  44. Gosling J.A. and Dixon J.S. Light and electron microscopic observations on the human external urethral sphincter. J. Anat. 129 (1979): 216.

    Google Scholar 

  45. von Hayek H. Das Faser kaliber in den mm. transversus perinei und sphincter urethrae. Z. Anat. Entwickl. Gesch. 121 (1969): 455.

    Article  Google Scholar 

  46. Gosling J.A., Dixon J.S., Critchley H.O.D. and Thompson S.A. A comparative study of the human external sphincter and periurethral levator ani muscles. Brit. J. Urol. 53 (1981): 35.

    Article  CAS  Google Scholar 

  47. Cass A.S. and Hinman F.J. Constant urethral flow in the female dog. J. Urol. 90 (1968): 442.

    Google Scholar 

  48. Tanagho E.A., Meyers F.H. and Smith D.R. Urethral resistance: its components and implications. II. Striated muscle component. Invest. Urol. 7 (1969): 195.

    PubMed  CAS  Google Scholar 

  49. Koff S.A. Striated muscle determinants of intra-urethral resistance. Invest. Urol. 15 (1977): 147

    PubMed  CAS  Google Scholar 

  50. McGuire E.J. and Wagner F.C. The effects of sacral denervation on bladder and urethral function. Surg., Gynec. Obst. 144 (1977): 343.

    CAS  Google Scholar 

  51. Westby M. and Asmussen M. The site of maximum urethral pressure and the location of the urogenital diaphragm in the female urethra as studied by simultaneous urethrocystometry and voiding urethrocystography. Proc. XI Annual Meeting I.C.S. Lund, p. 79 (1981).

    Google Scholar 

  52. Rud T. The striated pelvic floor muscles and their importance in maintaining urinary continence. Proc. 1st Joint. Meeting, X Annual Meeting I.C.S. — Urodynamics Society, Los Angeles, p. 79 (1980).

    Google Scholar 

  53. Constantinou C.E. and Go van D.E. Urodynamic analysis of urethral, vesical and perivesical pressure distribution in healthy female. Urol. Int. 35 (1980): 63.

    Article  PubMed  CAS  Google Scholar 

  54. Faysal M.H., Constantinou C.E., Rother L.F. and Govan D.E. The impact of bladder neck suspension on the resting and stress urethral pressure profile: a prospective study comparing controls with incontinent patients preoperatively and postoperatively. J. Urol. 125 (1981): 55.

    PubMed  CAS  Google Scholar 

  55. Toews H.A. Intraurethral and intravesical pressures in normal and stressincontinent women. Obstet. Gynecol. 29 (1981): 613.

    Google Scholar 

  56. Bunne G. and Öbrink A. Urethral closure pressure with stress-A comparison between stress-incontinent and continent women. Urol. Research. 6 (1978): 127–134.

    CAS  Google Scholar 

  57. Heidler H., Wölk H. and Jonas U. Urethral closure mechanism under stress conditions. Eur. Urol. 5 (1979): 110.

    PubMed  CAS  Google Scholar 

  58. Hilton P. and Stanton S.L. Urethral pressure measurement by microtransducer: the results in symptom-free women and in those with genuine stress incontinence. Brit. J. Obst. Gynec. 90 (1983): 919.

    Article  CAS  Google Scholar 

  59. Van der Kooi J.B., van Wanroy P.J.S., de Jonge M.C., Kornelis J.A. and van den Berg J. Microtip-manometer measurement of the time separation of cough pulses from the bladder and urethra in women. Proc. XII Annual Meeting I.C.S. Leiden, P. 9 (1982).60. Thüroff T.W., Bazeed M.A., Schmidt R.A. and Tanagho E.A. Mechanisms of urinary continence: an animal model to study urethral responses to stress conditions. J. Urol. 127 (1982): 1202.

    Google Scholar 

  60. Thüroff T.W., Bazeed M.A., Schmidt R.A. and Tanagho E.A. Mechanisms of urinary continence: an animal model to study urethral responses to stress conditions. J. Urol. 127 (1982): 1202

    PubMed  Google Scholar 

  61. Tanagho E.A., Miller E.R., Meyers F.H. and Corbett R.K. Observations on the dynamics of the bladder neck. Brit J. Urol. 38 (1966): 72.

    Article  PubMed  CAS  Google Scholar 

  62. Griffith D.J. The mechanics of the urethra and of micturition. Brit. J. Urol. 45 (1973): 497.

    Article  Google Scholar 

  63. Öbrink A., Bunne G. and Ulmsten U. Intraurethral and intravesical pressures in continent women. Acta Obstet. Gynec. Scand. 56 (1977): 525.

    Article  PubMed  Google Scholar 

  64. Kiruluta H.G., Downie J.W. and Awad S.A. The continence mechanisms: the effect of bladder filling on the urethra. J. Urol. 18 (1981): 460.

    CAS  Google Scholar 

  65. Henriksson L., Ulmsten U. and Andersson K.E. The effect of changes of posture on the urethral closure pressure in healthy women. Scand. J. Urol. Nephrol. 11 (1977): 201.

    Article  PubMed  CAS  Google Scholar 

  66. Witherow R.O. and Tiptaft R.C. The sitting and standing urethral pressure profile - a simple test for stress incontinence. Proc. VIII Annual Meeting I.C.S., Manchester (1978), p. 187.

    Google Scholar 

  67. Van Geelen J.M. The urethral pressure profile in continent women. Thesis Nijmegen. Publ.: Schriks Drukkerij B.V., Asten, The Netherlands (1983).

    Google Scholar 

  68. Ghoneim M.A., Rottembourg J.L., Fretin J. and Susset J.G. Urethral pressure profile. Standardization of Technique and Study of Reproducibility. Urology. V (1975): 632.

    Google Scholar 

  69. Bänninger U., Kunz J. and Reich P. Das Urethradruckprofil bei kontinenten und stressinkontinenten Frauen. Geburtsh. u. Frauenheilk. 40 (1980): 973.

    Article  CAS  Google Scholar 

  70. Hilton P. and Stanton S.L. Urethral pressure measurements by microtransducer: II. An analysis of rotational variations. Proc. XI Annual Meeting I.C.S., Lund, p. 70 (1981).

    Google Scholar 

  71. Ward H.H. and Hosker G.L. Anisotropic urethral occlusive forces. Proc. XII Annual Meeting I.C.S. Leiden (1982), p. 163.

    Google Scholar 

  72. Martinez F.C. and Constantinou C.E. Axial asymmetry of the resting urethral pressure profile in the continent female. Proc. XII Annual Meeting I.C.S. Leiden (1982), p. 55.

    Google Scholar 

  73. Edwards L. and Malvern J. The urethral pressure profile: theoretical considerations and clinical application. Brit. J. Urol. 46 (1974): 325.

    Article  PubMed  CAS  Google Scholar 

  74. Rud T. Urethral pressure profile in continent women from childhood to old age. Acta Obstet. Gynecol. Scand. 59 (1980): 331.

    Article  CAS  Google Scholar 

  75. Van Geelen J.M., Lemmens W.A.J.G., Eskes T.K.A.B. and Martin Jr. C.B. The urethral pressure profile in pregnancy and after delivery in healthy nulliparous women. Am. J. Obstet. Gynecol. 144 (1982): 636.

    PubMed  Google Scholar 

  76. Hilton P. and Stanton S.L. The use of intravaginal oestrogen cream in genuine stress incontinence. Brit. J. Obst. Gynec. 90 (1983): 940.

    Article  CAS  Google Scholar 

  77. Rud T. The effects of estrogens and gestagens on the urethral pressure profile in urinary continent and stress incontinent women. Acta Obstet. Gynecol. Scand. 59 (1980): 265.

    Article  CAS  Google Scholar 

  78. Richardson D.A., Bent A.E. and Ostergard D.R. The effect of uterovaginal prolaps on urethrovesical pressure dynamics. Am. J. Obstet. Gynecol. 146 (1983): 901.

    PubMed  CAS  Google Scholar 

  79. Plante P. and Susset J. Studies of female urethral pressure profile. Part I. The normal urethral pressure profile. J. Urol. 123 (1980): 64.

    PubMed  CAS  Google Scholar 

  80. Mattiasson A. On the peripheral nervous control of the lower urinary tract. Thesis, Lund (1984).

    Google Scholar 

  81. Beck R.P. and Maughan G.B. Simultaneous intraurethral and intravesical pressure studies in normal women and those with stress incontinence. Am. J. Obst. Gynecol. 89 (1964): 746.

    CAS  Google Scholar 

  82. Low J.A. and Kao M.S. Patterns of urethral resistance in deficient urethral sphincter function. Obstet. Gynecol. 40 (1972): 634.

    PubMed  CAS  Google Scholar 

  83. Awad S.A., Bryniak S.R., Lowe P.J., Bruce A.W. and Twiddy D.A.S. Urethral pressure profile in female stress incontinence. J. Urol. 120 (1978): 475.

    PubMed  CAS  Google Scholar 

  84. Henriksson L., Andersson K.E. and Ulmsten U. The urethral pressure profile in continent and stress incontinent women. Scand. J. Urol. Nephrol. 13, 5 (1979).

    Article  Google Scholar 

  85. Susset J. and Plante P. Studies of female urethral pressure profile. Part II. Urethral pressure profile in female incontinence. J. Urol. 123 (1980): 70.

    PubMed  CAS  Google Scholar 

  86. Eberhard J. and Lienhard P. Die Stressinkontinenz der Frau: Auswertung und Interpretation der Urethradruckprofile. Geburtsh. und Frauenheilh. 39 (1979): 195.

    CAS  Google Scholar 

  87. Lapides J., Ajemian E.P., Stewart B.H., Lichtwardt J.R. and Breakey B.A. Physiopathology of stressincontinence. Surg. Gynecol. Obstet. 1ll (1960): 224.

    Google Scholar 

  88. Radej M., Hitrec V., Krivea O., Kovacic M., Parazajder J. and Pavletic M. Functional and tonometric investigation of bladder and urethra in patients with stress incontinence. J. Urol. 115, 551 (1976).

    PubMed  CAS  Google Scholar 

  89. Gershon C.R. and Diokno A.C. Urodynamic evaluation of female stress urinary incontinence. J. Urol. 119 (1978): 787.

    PubMed  CAS  Google Scholar 

  90. Godec C.J., Esho J. and Cass A.S. Correlation among cystometry, urethral pressure profilometry and pelvic floor electromyography in the evaluation of female patients with voiding dysfunction symptoms. J. Urol. 124 (1980): 678.

    PubMed  CAS  Google Scholar 

  91. Öbrink A. and Bunne G. The margin to incontinence after three types of operation for stress incontinence. Scand. J. Urol. Nephrol. 12 (1978): 209.

    Article  PubMed  CAS  Google Scholar 

  92. Henriksson L. and Ulmsten U. A urodynamic evaluation of the effects of abdominal urethrocystopexy and vaginal sling urethroplasty in women with stress incontinence. Am. J. Obstet. Gynecol. 113 (1978): 78.

    Google Scholar 

  93. Constantinou C.E., Faysal M.H. and Govan D.E. The impact of bladder neck suspension on the mode of distribution of abdominal pressure along the female urethra. Proc. 10th Annual Meeting I.C.S., Los Angeles (1980).

    Google Scholar 

  94. Hilton P. and Stanton S.L. A clinical and urodynamic assessment of the Burch colposuspension for genuine stress incontinence. Brit. J. Obstet. Gynecol. 90 (1983): 934.

    Article  CAS  Google Scholar 

  95. Weil A., Reyes H., Bishoff P., Rottenberg R.D. and Krauer F. Modifications of the urethral rest and stress profiles after different types of surgery for urinary stress incontinence. Brit. J. Obstet. Gynecol. 91 (1984): 46.

    CAS  Google Scholar 

  96. Ulmsten U., Henriksson L. and Iosif S. The unstable urethra. Am. J. Obstet. Gynecol. 144 (1982): 93.

    PubMed  CAS  Google Scholar 

  97. Kulseng Hanssen S. Prevalence and pattern of unstable urethral pressures in one hundred seventy-four gynecologic patients referred for urodynamic investigation. Am. J. Obstet. Gynecol. 146 (1983): 893.

    Google Scholar 

  98. McGuire E.J. Reflex urethral instability. Brit. J. Urol. 50 (1978): 200.

    Article  PubMed  CAS  Google Scholar 

  99. Harrison N.W. The urethral pressure profile. Urol. Res. 4 (1976): 95.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. J. M. van Geelen
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Urology, University Hospital St. Radboud, Nijmegen, The Netherlands

    F. M. J. Debruyne  & Ph. E. V. A. van Kerrebroeck  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1986 Martinus Nijhoff Publishers, Dordrecht

About this chapter

Cite this chapter

van Geelen, J.M. (1986). The value of the urethral pressure profile. In: Debruyne, F.M.J., van Kerrebroeck, P.E.V.A. (eds) Practical Aspects of Urinary Incontinence. Developments in Surgery, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4237-0_4

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-4237-0_4

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8381-2

  • Online ISBN: 978-94-009-4237-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation