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Intravesical and intra-urethral pressures were recorded in 5 continent women and 10 women with urinary stress incontinence using combined urethrocystometry and cinefluorography. At rest, two types of stress incontinence could be recognized; one involved widening of the proximal urethra and the other did not. Under stress, the proximal urethra was rather mobile in the incontinent women. Artifacts caused by axial movement of the urethral microtransducer were eliminated by fixation of the catheter against the external meatus.

In 21 women undergoing simultaneous urethrocystometry because of dysuria, urge, and difficulties to empty the bladder, the effects of prostaglandin E2 (PGE2) applied locally in the bladder and urethra were investigated. In all 9 patients receiving PGE2 intravesically, the bladder pressure increased. Simultaneously, there was a signficant decrease in maximum urethral pressure (p less than 0.05), and in urethral closure pressure (p less than 0.005). Residual urine decreased in the 4 patients, in whom it exceeded 50 ml before administration. All 12 patients receiving PGE2 intraurethrally showed a decrease in maximum urethral pressure). There was a significant increase in bladder pressure (p less than 0.05); urethral closure pressure decreased in all patients. Bladder capacity decreased significantly (p less than 0.01). Residual urine exceeding 50 ml was found in 6 patients; it decreased in 4 after PGE2 administration. It is concluded that PGE2 applied intraurethrally can decrease the intraurethral pressure and increase the bladder pressure without side effects. By these actions, the drug might be useful for facilitating bladder emptying in patients with acute retention of urine.

The effect of changes of posture on hydrodynamic parameters considered important for the maintenance of urinary continence was investigated in 14 healthy women. The subjects were investigated in the supine and erect positions using a previously described technique for simultaneous urethrocystometry, including recording of the urethral pressure profile. It was found that a change from the supine to the standing position increased the maximum intravesical pressure from a mean value of 13 mmHg to 22 mmHg. There was a simultaneous increase in the maximum intra-urethral pressure from a mean of 66 mmHg to 82 mmHg. As a consequence, the urethral closure pressure increased from a mean of 53 mmHg to 60 mmHg. The functional length of the urethra increased from 25 mm to 28 mm, and the absolute length from 28 mm to 36 mm. It is concluded that in healthy women, a change from the supine to the standing position causes a rise in the maximum intra-urethral pressure and an increase in the absolute and functional lengths of the urethra. These effects counteract the simultaneous increase in bladder pressure, and can be regarded as compensatory mechanisms for the maintenance of continence.