Stress urinary incontinence

Abstract

Stress urinary incontinence (SUI) is the involuntary loss of urine associated with an increase in intraabdominal pressure, such as with coughing or other physical activity (see Chapter 1.5). Continence during raised intraabdominal pressure is attributable to an integrated system of muscles, fascia, ligaments, and neural control (see Chapters 1.1 and 1.2). The connection of the levator ani to the arcus tendineus fascia pelvis permits active contraction of the PFMs to elevate and support the anterior vaginal wall. 1 In addition, continence also requires a competent urethral sphincter mechanism. Evidence suggests that a voluntary PFM contraction is accompanied by synergistic contraction of the urethral sphincter mechanism, 2 indicating that both components of the continence mechanism should respond to muscle training. © 2008 Springer-Verlag London.