2023, Number 6
Next >>
Rev Mex Urol 2023; 83 (6)
Effects on urethral maximum closing pressure during voluntary contraction of pelvic floor muscles in women
Loya-Maldonado KM, Gutiérrez-González A, Guerrero-Reyes G, Hernández-Velázquez R, Pallárez-Méndez R, Robledo-Torres A, Reyes-Alcaraz JE, Treviño-Cavazos O, Leyva-Vázquez JI, Chávez-Loya DA
Language: English
References: 13
Page: 1-10
PDF size: 269.08 Kb.
ABSTRACT
Introduction: Pelvic floor muscle exercises represent voluntary contractions
and relaxations of the levator ani muscles. This muscle group gives support to
the vagina, bladder, and urethra.
Urethral profilometry is a study that assesses the closing function of the
urethral sphincter. There is limited scientific evidence regarding the changes in
pressure values of the Maximum Urethral Closing Pressure (MUCP) during a
voluntary contraction of the pelvic floor muscles (C-MUCP).
Objective: During a urodynamic test, evaluate the change in MUCP at rest
and during voluntary contraction after verbal command, in patients from two
tertiary referral hospitals.
Material and methods: Retrospective and cross-sectional study of two tertiary
referral hospitals in Mexico. This study focused on reviewing hospital records
of adult patients who underwent a urodynamic study from January 2016 to
February 2022. Obstetric clinical history data and MUCP results at rest and
in C-MUCP during urodynamics were taken. IBM SPSS Statistics version 22
statistical program was used.
Results: 928 patients with a mean age of 58 years were evaluated. Eighty three
percent were postmenopausal women. An inverse relationship was observed
between age and MUCP both at rest (p=‹0.001) and in C-MUCP (p=0.009).
Neurogenic disease and postmenopausal status had no significant relationship
with the ability to increase MUCP. Sixty five percent of the population achieved
a clinically significant increase of the MUCP.
Conclusion: There is a direct negative relationship between age, resting MUCP
and C-MUCP. In patients with both neurogenic and non-neurogenic pathology,
the rate of clinically significant increase in MUCP was low.
REFERENCES
Dumoulin C, Cacciari LP, Hay-Smith EJC.Pelvic floor muscle training versus no treatment,or inactive control treatments, for urinaryincontinence in women. The Cochrane Databaseof Systematic Reviews. 2018;10: CD005654.https://doi.org/10.1002/14651858.cd005654.pub4.
Sheng Y, Liu X, Low LK, Ashton-Miller JA,Miller JM. Association of pubovisceral muscletear with functional capacity of urethral closure:evaluating maternal recovery from labor anddelivery. American Journal of Obstetrics andGynecology. 2020;222(6): 598.e1-598.e7.https://doi.org/10.1016/j.ajog.2019.11.1257.
Marques A, Stothers L, Macnab A. The statusof pelvic floor muscle training for women.Canadian Urological Association Journal = JournalDe l’Association Des Urologues Du Canada.2010;4(6): 419–424. https://doi.org/10.5489/cuaj.10026.
Kegel AH. Progressive resistance exercisein the functional restoration of the perinealmuscles. American Journal of Obstetrics andGynecology. 1948;56(2): 238–248. https://doi.org/10.1016/0002-9378(48)90266-x.
Dietz HP, Shek KL. Levator function andvoluntary augmentation of maximum urethralclosure pressure. International UrogynecologyJournal. 2012;23(8): 1035–1040. https://doi.org/10.1007/s00192-012-1705-3.
Basnet R. Impact of pelvic floor muscletraining in pelvic organ prolapse. InternationalUrogynecology Journal. 2021;32(6): 1351–1360.https://doi.org/10.1007/s00192-020-04613-w.
Zubieta M, Carr RL, Drake MJ, Bø K. Influenceof voluntary pelvic floor muscle contractionand pelvic floor muscle training on urethralclosure pressures: a systematic literature review.International Urogynecology Journal. 2016;27(5):687–696. https://doi.org/10.1007/s00192-015-2856-9.
Bø K. Pelvic floor muscle training is effective intreatment of female stress urinary incontinence,but how does it work? International UrogynecologyJournal and Pelvic Floor Dysfunction. 2004;15(2):76–84. https://doi.org/10.1007/s00192-004-1125-0.
Bump RC, Hurt WG, Fantl JA, Wyman JF.Assessment of Kegel pelvic muscle exerciseperformance after brief verbal instruction.American Journal of Obstetrics and Gynecology.1991;165(2): 322–327; discussion 327-329.https://doi.org/10.1016/0002-9378(91)90085-6.
van Loenen NT, Vierhout ME. Augmentationof urethral pressure profile by voluntary pelvicfloor contraction. International UrogynecologyJournal and Pelvic Floor Dysfunction. 1997;8(5):284–287. https://doi.org/10.1007/bf02765485.
Rosier PFWM, Kuo HC, De Gennaro M,Gammie A, Finazzi Agro E, Kakizaki H, etal. International Consultation on Incontinence2016; Executive summary: Urodynamic testing.Neurourology and Urodynamics. 2019;38(2):545–552. https://doi.org/10.1002/nau.23903.
Weber AM. Is urethral pressure profilometrya useful diagnostic test for stress urinaryincontinence? Obstetrical & GynecologicalSurvey. 2001;56(11): 720–735. https://doi.org/10.1097/00006254-200111000-00024.
Dompeyre P, Fritel X, Fauconnier A, Robain G.Contraction des muscles du plancher pelvien etpression de clôture urétrale maximale. Progrèsen Urologie. 2015;25(4): 200–205. https://doi.org/10.1016/j.purol.2014.10.010.