Electromyographic study of the striated urethral sphincter in type 3 stress incontinence: evidence of myogenic-dominant damages

Objectives. To determine the electromyographic features of the striated urethral sphincter in patients with type 3 stress incontinence (SI) due to intrinsic sphincteric deficiency (ISD). Methods. We performed electromyography (EMG) of the striated urethral sphincter muscle and urodynamic studies in...

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Published in:	Urology (Ridgewood, N.J.) Vol. 56; no. 6; pp. 946 - 950
Main Authors:	Takahashi, Satoru, Homma, Yukio, Fujishiro, Tetsuyuki, Hosaka, Yoshio, Kitamura, Tadauchi, Kawabe, Kazuki
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-12-2000 Elsevier Science
Subjects:	Aged Biological and medical sciences Electromyography - statistics & numerical data Female Humans Medical sciences Middle Aged Muscle, Skeletal - physiopathology Muscular Diseases - diagnosis Muscular Diseases - physiopathology Nephrology. Urinary tract diseases Urethra - physiopathology Urinary Incontinence, Stress - diagnosis Urinary Incontinence, Stress - etiology Urinary Incontinence, Stress - physiopathology Urinary system involvement in other diseases. Miscellaneous Urinary tract. Prostate gland Human Urine Electrodiagnosis Voiding dysfunction Urinary system disease Dynamics Etiology Bladder disease Electromyography Urinary tract disease Musculus sphincter urethral Urinary stress incontinence
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Summary:	Objectives. To determine the electromyographic features of the striated urethral sphincter in patients with type 3 stress incontinence (SI) due to intrinsic sphincteric deficiency (ISD). Methods. We performed electromyography (EMG) of the striated urethral sphincter muscle and urodynamic studies in a total of 51 women, 41 female patients with type 3 SI and 10 women with normal urinary control (NUC). The results were analyzed in both groups, and the correlation of EMG findings with the patient characteristics and urodynamic parameters was evaluated. Results. Motor unit potentials (MUP) of SI patients showed significantly shorter duration ( P = 0.0014), lower amplitude ( P = 0.0008), and larger number of phases ( P = 0.0022) compared with those in the NUC group. Thirty (73%) of the SI patients showed an obvious low amplitude (less than 350 μV)/short duration (less than 4.5 milliseconds)/polyphasic pattern and early recruitment of interference activity with low amplitude at voluntary contraction of the striated sphincter, both indicating existence of myogenic damages. These patients showing myogenic damages had significantly lower Valsalva leak point pressure ( P = 0.002) and more leakage in the pad-weigh test ( P = 0.010) compared with the SI patients without myogenic damage findings. Conclusions. These results suggested that myogenic-dominant damages of the striated urethral sphincter may contribute to the etiology of ISD in most patients with type 3 SI.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0090-4295 1527-9995
DOI:	10.1016/S0090-4295(00)00794-9