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. 2024 Sep;43(7):1647-1654.
doi: 10.1002/nau.25489. Epub 2024 May 22.

The female urethral closure mechanism during physical stress

Pieter L Venema  1 , John Pfa Heesakkers  1 , Allert M de Vries  1 , Gommert A van Koeveringe  1
Affiliations

The female urethral closure mechanism during physical stress

Pieter L Venema et al. Neurourol Urodyn. 2024 Sep.

Abstract

The closure of the urethra under the condition of stress is the result of a reflex contraction of the urethral rhabdosphincter and pelvic floor muscles. This is likely induced by activity of the abdominal muscles due to a sudden increase in abdominal pressure. This reflex contraction with an increase of urethral pressure occurs a few milliseconds before an increase in intraabdominal pressure. The urethral pressure increase during stress is only possible with fixation of the urethra by the pubourethral ligaments (PUL), facilitating urethral kinking. The highest and most important increase in pressure and resistance occurs in the distal urethra due to this kinking of the urethra.

Keywords: anatomy; compressor urethrae; female stress urinary incontinence; pubourethral ligaments; reflex contraction; urethral kinking; urethral sphincter.

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References

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