SPHINCTEROMETRY OF THE FEMALE URETHRA

Abstract

A new device for sphincterometry of the female urethra is described: a water tank, a piston pump, a variable microcock, a flow-meter, and an urethral adapter with cone-shaped tip are attached to an autorecording manometer. The tonus of the external urethral sphincter, strictly speaking the intraurethral pressure is measured and recorded, while water is flowing through the urethra under constant flow rate (50cc/min).
Sphincterometrograms were analysed by two elements; tonicity (height of pressure) and wave pattern. Sphincterometrogram in the healthy female shows 40-80mmHg of tonicity with regular wave pattern; in children it is slightly hypotonic. In complete incontinence it is very hypotonic with flat wave pattern. In stress incontinence the sphincterometrogram is similar to complete incontinence, but cases which are hypertonic, always are complicated with inflammation of the bladder neck. In neurogenic bladder after hysterectomy it is slightly or very hypotonic with almost flat wave pattern, whereas cystometrogram is very hypertonic. The neurogenic bladder symptom after hysterectomy is of a special type, which is not purely defined to be a atonic bladder nor a sensory neurogenic bladder, but seems rather to be a combinred form of stress incontinence and over-flow incontinence. Enuresis shows normal sphincterometrogram. In uninhibited bladder it is hypertonic with special wave pattern. In contracted bladder it is very hypertonic with flat wave pattern.