Pseudomyotonia of the periurethral sphincter in women with urinary incontinence

Needle electromyography demonstrated bizarre repetitive high frequency discharges of the periurethral muscles in 3 women with urinary incontinence. One patient recovered spontaneously and 2 had associated stress incontinence that was greatly accentuated. Surgical correction of the stress incontinence had been done in 1 woman before the sphincter neuropathy was recognized and she continued to experience severe incontinence unrelated to activity for 30 months while the neuropathy subsided and stabilized. The second patient with stress incontinence and sphincter pseudomyotonia was diagnosed preoperatively. The operation was delayed for a year until the peripheral neuropathy appeared to be stabilized. This case had a more predictable and satisfactory postoperative result. The experience with these patients suggests that other specific neurogenic disorders of the striated sphincters may cause significant urologic symptoms.