[Manometric measurement of contraction capability of pelvic floor muscles]

The objective of our investigation was to introduce manometric assessment of the force of contraction of pelvic floor muscles as one of the examination methods for confirming the diagnosis of assessment of the degree of urinary incontinence in women; also to assess the relationship between MUCP (maximal urethral closure pressure), PWT (pad weight test) and results of manometric assessment. The trial comprised 10 healthy premenopausal and 10 postmenopausal women who did not suffer from incontinence. The authors investigated also 20 premenopausal women with the stress type of incontinence and 20 postmenopausal ones. In all manometric assessments with a WISAP apparatus were made. The maximal increase of pressure was recorded during contraction of the entire pelvic floor and when the pressure in the balloon was set at 50 and 75 mm Hg. During this assessment the authors recorded also a statistically significant difference between the group also a statistically significant difference between the group of continent and incontinent women before the menopause. No relationship between MUCP, PWT and the maximal contraction capacity of the pelvic floor muscles was found. The disadvantage of the manometric apparatus WISAP is the calibration of the apparatus in mm Hg (1 mm Hg = 13.5 cm water), i.e. the low sensitivity of the apparatus and the shape of the balloons which leads to irregular expression from the vagina during contraction of the pelvic floor muscles. From absolute values of the contraction force of the pelvic floor muscles we cannot draw any conclusions on urinary incontinence or its grade. The authors recommend this method only as a supplementary one, in particular to evaluate the results of exercise of the pelvic floor muscles.