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International Urogynecology Journal
Published in: International Urogynecology Journal 7/2022

10-05-2022 | Stress Incontinence | Letter to the Editor

The abdominal pressure theory of stress urinary incontinence—questioning validity

Author: Darren M. Gold

Published in: International Urogynecology Journal | Issue 7/2022

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Excerpt

I read Dr Bergstrom’s recent publication with interest and from a specifically scientific perspective. His “urethral hanging hypothesis” (UHT) [1] mimics the Integral Theory (IT) that a sound pubourethral ligament (PUL) is key to urethral closure [2]. One difference is Dr Bergstrom (without any experimental proof) proposes PUL as a fracture (his Fig. 1), whereas the IT states PUL “laxity” is due to defective collagen, proven by the application of the mid-urethral sling (MUS), which harnesses the wound reaction of an implanted tape to create new collagen to repair PUL [2]. …
Literature
1.
Bergström BS. Stress urinary incontinence is caused predominantly by urethral support failure. Int Urogynecol J. 2022;33(3):523–30.CrossRef
2.
Petros PE, Ulmsten UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl. 1990;153:7–31.CrossRef
3.
Kamo I, et al. Two kinds of urinary continence reflexes during abrupt elevation of intravesical pressure in rats. Low Urin Tract Symptoms. 2009;1(s1):S40–s43.CrossRef
4.
Constantinou CE, Govan DE. Contribution and timing of transmitted and generated pressure components in the female urethra. Prog Clin Biol Res. 1981;78:113–20.PubMed
5.
Bush MB, et al. A finite element model validates an external mechanism for opening the urethral tube prior to micturition in the female. World J Urol. 2015;33(8):1151–7.CrossRef
Metadata
Title
The abdominal pressure theory of stress urinary incontinence—questioning validity
Author
Darren M. Gold
Publication date
10-05-2022
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 7/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-022-05211-8

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