Time separation between cough pulses in bladder, rectum and urethra in women.

Time separations between cough pulses detected by microtip transducer catheters in bladder, urethra and rectum were studied in 10 healthy female volunteers, 10 genuine stress incontinents, 10 motor urge incontinents and 9 motor urge incontinents after bladder retraining. From the measurements that could be analyzed in the group of volunteers, 25 per cent showed a significant advanced onset of the pressure rise in the urethra and 50 per cent a prolonged duration of the urethral cough pulses. None demonstrated delayed onset or shortened duration compared to the vesical pulses. In the genuine stress incontinent group none of the women had an advanced urethral start whilst the motor urge incontinents had figures somewhere in between, except for a remarkable prolonged duration of the urethral cough pulse in the bladder retrained women. The data obtained can be explained by introducing, besides the passive transmission of abdominal pressure, a 2nd component actively engaged in maintaining continence.