The urethral hanging theory and how it relates to Enhörning’s theory and the integral theory

Abstract

Introduction and hypothesis: The article discusses three theories of stress urinary incontinence, the urethral hanging theory, Enhörning’s theory, and the integral theory. Methods: The abdominal pressure transmission theory proposed by Enhörning is often misunderstood. It is regularly interpreted to mean that, in cases of stress urinary incontinence, the bladder neck descends outside the abdominal cavity, and treatment must involve elevating or repositioning the bladder neck. Results: However, this actually contradicts the information provided in Enhörning’s original paper. The urethral hanging theory accepts the core of Enhörning’s theory and the integral theory rejects it. The three theories have different views on closure and opening of the bladder neck and on the pathophysiology of urethral funneling. Conclusion: These differences are described and discussed.