Diagnostic and therapeutic aspects of urge urinary incontinence in women

Under standardized conditions, simultaneous urethrocystometry and recording of urethral pressure profile were performed in 10 healthy volunteers and 20 patients suffering from urge incontinence. In the normal subjects, desire to void occurred at a bladder volume of about 300 cm3. At maximum bladder capacity (approximately 500 cm3), variations in intraurethral pressure were recorded at a time when the intravesical pressure remained stable. Immediately before voiding, there was a marked reduction in intraurethral pressure and then the intravesical pressure increased. In 10 of the patients with symptoms of urge incontinence, the findings did not differ from those in the normal subjects. In the other 10 patients, urgency was reported at bladder volumes between 125 and 150 cm3, and the maximum bladder capacity did not exceed 200 cm3. In 8 of them, marked variations in intraurethral pressure were recorded when urge was experienced, whereas the bladder pressure remained stable. In 2 of the patients, variations in intraurethral and intravesical pressure occurred simultaneously. The role of the urethra in urge incontinence is discussed.