Studies of female urethral pressure profile. Part II. Urethral pressure profile in female incontinence.

Most pressure values, except U1 and areas under the curve, were significantly lower in the 456 curves obtained in 38 incontinent women than in normal subjects. Standard deviations of all parameters are important because of variations in the degree of patient relaxation, explaining a large overlapping zone in which curves from the incontinent and the normal groups are superimposed. There are 3 factors that cause a reduction in urethral pressure profile: 1) aging and menopause (which are attributed to reduction in urethral compliance), 2) multiparity and 3) previous significant urogynecological operations. Besides urethral compliance urethral pressure profile studies allow measurement of 5 other components of the urethral resistance: 1) the degree of patency of the vesical neck, 2) the maximum voluntary sphincter contraction, 3) the functional urethral length, 4) the facilitatory urethral relaxation reflex and 5) the degree of urethral displacement to some extent. Separate measurements of each urethral factor should allow a more accurate analysis of urethral resistance and, consequently, enhance the quality of therapeutic indications in the management of female incontinence.