Mechanisms of female urinary continence under stress: Frequency spectrum analysis

Kyu Jung Kim, Catalin D. Jurnalov, Seung Yong Ham, Maurice J. Webb, Kai Nan An

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Intravesical and urethral pressure signals during cough and Valsalva maneuvers for 15 continent women were analyzed with frequency spectrum analysis. Clear modulation of the urethral pressure changes by the intravesical pressure rise during stress maneuvers was demonstrated in the frequency bands of 14 and 7Hz for cough and Valsalva, respectively. The linearity between the urethral and intravesical pressure signals was strong for cough, but relatively weaker for Valsalva. The observed linearity lead to the formulation of a modified continence equation to mathematically quantify stress leak point pressure (sLPP): sLPP=MUCP/(1-α1)+RBP. This algebraic equation demonstrated that sLPP depends on pressure transmission, resting bladder pressure, and maximum urethral closure pressure. The equation was validated with excellent theoretical predictions for the 15 continent subjects (R2=0.98 and 0.97 for cough and Valsalva leak point pressure, respectively) and good but somewhat weaker predictions for 46 stress incontinent women (R2=0.79 and 0.48, respectively). It has been shown that pressure transmission plays the most important role in female continence function, while it may be attributable to passive structural origin as evidenced by the minimal time delay between the two pressure signals, in the order of a few milliseconds. It can be concluded that coughing seems to have a more mechanical, rather than neuromuscular basis for its signal dynamics. This study suggests that a complete assessment of female stress continence function requires comprehensive urodynamic information in terms of pressure transmission, maximum urethral closure pressure, and resting bladder pressure.

Original languageEnglish (US)
Pages (from-to)687-691
Number of pages5
JournalJournal of Biomechanics
Volume34
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Spectrum analysis
Spectrum Analysis
Pressure
Cough
Urinary Bladder
Valsalva Maneuver
Urodynamics
Frequency bands
Time delay

Keywords

  • Biomechanics
  • Female
  • Urethra
  • Urinary incontinence
  • Urodynamics

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Mechanisms of female urinary continence under stress : Frequency spectrum analysis. / Kim, Kyu Jung; Jurnalov, Catalin D.; Ham, Seung Yong; Webb, Maurice J.; An, Kai Nan.

In: Journal of Biomechanics, Vol. 34, No. 5, 2001, p. 687-691.

Research output: Contribution to journalArticle

Kim, Kyu Jung ; Jurnalov, Catalin D. ; Ham, Seung Yong ; Webb, Maurice J. ; An, Kai Nan. / Mechanisms of female urinary continence under stress : Frequency spectrum analysis. In: Journal of Biomechanics. 2001 ; Vol. 34, No. 5. pp. 687-691.
@article{6de35535d2ee47bda13d0f43a4ce7cd7,
title = "Mechanisms of female urinary continence under stress: Frequency spectrum analysis",
abstract = "Intravesical and urethral pressure signals during cough and Valsalva maneuvers for 15 continent women were analyzed with frequency spectrum analysis. Clear modulation of the urethral pressure changes by the intravesical pressure rise during stress maneuvers was demonstrated in the frequency bands of 14 and 7Hz for cough and Valsalva, respectively. The linearity between the urethral and intravesical pressure signals was strong for cough, but relatively weaker for Valsalva. The observed linearity lead to the formulation of a modified continence equation to mathematically quantify stress leak point pressure (sLPP): sLPP=MUCP/(1-α1)+RBP. This algebraic equation demonstrated that sLPP depends on pressure transmission, resting bladder pressure, and maximum urethral closure pressure. The equation was validated with excellent theoretical predictions for the 15 continent subjects (R2=0.98 and 0.97 for cough and Valsalva leak point pressure, respectively) and good but somewhat weaker predictions for 46 stress incontinent women (R2=0.79 and 0.48, respectively). It has been shown that pressure transmission plays the most important role in female continence function, while it may be attributable to passive structural origin as evidenced by the minimal time delay between the two pressure signals, in the order of a few milliseconds. It can be concluded that coughing seems to have a more mechanical, rather than neuromuscular basis for its signal dynamics. This study suggests that a complete assessment of female stress continence function requires comprehensive urodynamic information in terms of pressure transmission, maximum urethral closure pressure, and resting bladder pressure.",
keywords = "Biomechanics, Female, Urethra, Urinary incontinence, Urodynamics",
author = "Kim, {Kyu Jung} and Jurnalov, {Catalin D.} and Ham, {Seung Yong} and Webb, {Maurice J.} and An, {Kai Nan}",
year = "2001",
doi = "10.1016/S0021-9290(01)00006-9",
language = "English (US)",
volume = "34",
pages = "687--691",
journal = "Journal of Biomechanics",
issn = "0021-9290",
publisher = "Elsevier Limited",
number = "5",

}

TY - JOUR

T1 - Mechanisms of female urinary continence under stress

T2 - Frequency spectrum analysis

AU - Kim, Kyu Jung

AU - Jurnalov, Catalin D.

AU - Ham, Seung Yong

AU - Webb, Maurice J.

AU - An, Kai Nan

PY - 2001

Y1 - 2001

N2 - Intravesical and urethral pressure signals during cough and Valsalva maneuvers for 15 continent women were analyzed with frequency spectrum analysis. Clear modulation of the urethral pressure changes by the intravesical pressure rise during stress maneuvers was demonstrated in the frequency bands of 14 and 7Hz for cough and Valsalva, respectively. The linearity between the urethral and intravesical pressure signals was strong for cough, but relatively weaker for Valsalva. The observed linearity lead to the formulation of a modified continence equation to mathematically quantify stress leak point pressure (sLPP): sLPP=MUCP/(1-α1)+RBP. This algebraic equation demonstrated that sLPP depends on pressure transmission, resting bladder pressure, and maximum urethral closure pressure. The equation was validated with excellent theoretical predictions for the 15 continent subjects (R2=0.98 and 0.97 for cough and Valsalva leak point pressure, respectively) and good but somewhat weaker predictions for 46 stress incontinent women (R2=0.79 and 0.48, respectively). It has been shown that pressure transmission plays the most important role in female continence function, while it may be attributable to passive structural origin as evidenced by the minimal time delay between the two pressure signals, in the order of a few milliseconds. It can be concluded that coughing seems to have a more mechanical, rather than neuromuscular basis for its signal dynamics. This study suggests that a complete assessment of female stress continence function requires comprehensive urodynamic information in terms of pressure transmission, maximum urethral closure pressure, and resting bladder pressure.

AB - Intravesical and urethral pressure signals during cough and Valsalva maneuvers for 15 continent women were analyzed with frequency spectrum analysis. Clear modulation of the urethral pressure changes by the intravesical pressure rise during stress maneuvers was demonstrated in the frequency bands of 14 and 7Hz for cough and Valsalva, respectively. The linearity between the urethral and intravesical pressure signals was strong for cough, but relatively weaker for Valsalva. The observed linearity lead to the formulation of a modified continence equation to mathematically quantify stress leak point pressure (sLPP): sLPP=MUCP/(1-α1)+RBP. This algebraic equation demonstrated that sLPP depends on pressure transmission, resting bladder pressure, and maximum urethral closure pressure. The equation was validated with excellent theoretical predictions for the 15 continent subjects (R2=0.98 and 0.97 for cough and Valsalva leak point pressure, respectively) and good but somewhat weaker predictions for 46 stress incontinent women (R2=0.79 and 0.48, respectively). It has been shown that pressure transmission plays the most important role in female continence function, while it may be attributable to passive structural origin as evidenced by the minimal time delay between the two pressure signals, in the order of a few milliseconds. It can be concluded that coughing seems to have a more mechanical, rather than neuromuscular basis for its signal dynamics. This study suggests that a complete assessment of female stress continence function requires comprehensive urodynamic information in terms of pressure transmission, maximum urethral closure pressure, and resting bladder pressure.

KW - Biomechanics

KW - Female

KW - Urethra

KW - Urinary incontinence

KW - Urodynamics

UR - http://www.scopus.com/inward/record.url?scp=0035062094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035062094&partnerID=8YFLogxK

U2 - 10.1016/S0021-9290(01)00006-9

DO - 10.1016/S0021-9290(01)00006-9

M3 - Article

C2 - 11311710

AN - SCOPUS:0035062094

VL - 34

SP - 687

EP - 691

JO - Journal of Biomechanics

JF - Journal of Biomechanics

SN - 0021-9290

IS - 5

ER -