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Published on: August 28, 2020
The Urethral Hanging Theory: A Unified Biomechanical Model for the Pathophysiology and Treatment of Female Urinary
Bo S Bergström1,2,3
1Years from 1988 to 2000, chief of the Department of Obstetrics & Gynecology, Mora Hospital, Lasarettsvägen 35, 792 51, Mora, Sweden. bbrgstrm@gmail.com.
Introduction And Hypothesis:
The pathophysiology of female urinary incontinence (UI) is often considered complex and poorly understood, partly due to the limitations of prevailing theories such as the integral theory and the hammock theory, both of which contradict established physical laws. This article introduces the urethral hanging theory (UHT) as a unified biomechanical model that explains stress urinary incontinence (SUI), mixed urinary incontinence (MUI), intrinsic sphincter deficiency (ISD), and idiopathic urge urinary incontinence (UUI) as a continuum of funneling-related pathologies.
Methods:
Anatomical analysis, physical principles, published work by others, clinical experience, and mental simulations were used to develop the model. The UHT attributes symptoms to differential mobility-a mechanical imbalance-between the urethra and the bladder neck, resulting in varying degrees of funneling during physical strain.
Results:
The theory provides a physically consistent framework that explains symptom variation across different types of UI and unifies them with a single biomechanical continuum. This framework also offers guidance for individualized surgical interventions.
Conclusion:
If validated clinically, the UHT could substantially improve diagnostic precision and treatment outcomes for female urinary incontinence.
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