[Does perineal muscle testing provide information on the quality of the urethral sphincter in women?]

A prospective study was carried out on 100 women presenting with urinary incontinence with the intent of determining whether a relationship could be found between the quality of the perineal musculature, as assessed by testing the levatores, and that of the urethral sphincters, as assessed by a study of the urethral pressure profile, thereby defining the respective importance of each of these tests. The mean maximum closing pressure values were compared for three groups whose testing was scored good, fair or nil. Evidence of a positive relationship existing between the levatores testing and the maximum closing pressure against rest (p less than 0.05) and stress (holding-back) (p less than 0.01) urethral pressure profiles was brought forth. However, this relationship does not allow to extrapolate the testing results to the sphinters. In practice, at the individual patient level, one may be satisfied by merely testing the pelvic musculature in case of reeducational treatment of incontinence. Nevertheless, whenever surgery is indicated, objective assessment of the urethral sphincters by ways of an urethral pressure profile study is mandatory.