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Continent women have better urethral neuromuscular function than those with stress incontinence

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Abstract

Introduction and hypothesis

The objective of this study is to describe urethral neuromuscular function using concentric needle electromyography (EMG) in stress incontinent (SUI) and asymptomatic women.

Methods

Following Institutional Review Board approval, we recruited SUI and asymptomatic women without urinary incontinence. Participants underwent quantitative urethral EMG and urodynamic testing.

Results

Sixty-seven women (37 SUI, 30 continent) with mean ± SD age of 44 ± 12 years participated. Nearly all EMG parameters showed significant differences between continent and SUI women consistent with better motor unit recruitment in continent women. Continent women had larger-amplitude, longer-duration motor unit action potentials (MUP) with increased turns and better MUP recruitment during bladder filling (P < .05). Increasing age was inversely correlated with nearly all MUP parameters (P < .05), suggesting MUP to be consistent with neuropathy.

Conclusions

We found significant differences in multiple MUP parameters in urethral sphincter between continent and stress incontinent women, suggesting continent women have better urethral innervation. We also found significant neuropathic MUP changes with advancing age, regardless of continence status.

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Acknowledgements

This study was supported by The Eunice Kennedy Schriver National Institute of Child Health and Human Development K23HD047325-05 and National Institute of Diabetes and Digestive and Kidney Disease K24 DK064044-03, with IRB approval no. 107881111704.

Conflicts of interest

Dr. Mueller is a study investigator for Pfizer and Allergan, as she is a consultant for BK Ultrasound.

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Authors and Affiliations

  1. Division of Female Pelvic Medicine & Reconstructive Surgery, Departments of Obstetrics & Gynecology and Urology, Loyola University Stritch School of Medicine, 2160 South First Avenue, Maywood, IL, 60153, USA

    Kimberly Kenton, Elizabeth Mueller & Linda Brubaker

Authors
  1. Kimberly Kenton
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  2. Elizabeth Mueller
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  3. Linda Brubaker
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Corresponding author

Correspondence to Kimberly Kenton.

Additional information

A related editorial can be found at doi:10.1007/s00192-011-1570-5 and related articles at doi:10.1007/s00192-011-1485-1 and doi:10.1007/s00192-011-1539-4.

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Kenton, K., Mueller, E. & Brubaker, L. Continent women have better urethral neuromuscular function than those with stress incontinence. Int Urogynecol J 22, 1479–1484 (2011). https://doi.org/10.1007/s00192-011-1447-7

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  • DOI: https://doi.org/10.1007/s00192-011-1447-7

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