Cough transmission pressure to the bladder and urethra among continent and incontinent elderly women

Abstract

Although cough transmission pressures to the bladder and urethra are now being measured as part of the evaluation of an incontinent woman, there has not been a comprehensive study specifically focused among continent and incontinent non-institutionalized elderly women in order to understand the meaning of such measurements. To determine the characteristics and significance of the cough transmission pressures to the bladder and urethra, measurements were obtained from 69 continent and 100 incontinent elderly female respondents as part of an extensive urodynamic testing. Results showed that during coughing in the standing position, the increase in bladder pressure is significantly stronger among stress incontinent respondents than among continent and non-stress incontinent respondents (p = 0.0022). The increase in urethral pressure in the same group is marginally significant (p = 0.066). The mean transmission pressure ratio (urethral pressure ÷ bladder pressure) is less than 100% in all groups. They were higher among continent respondents (90%) and non-stress incontinent respondents (97%) than stress incontinent respondents (83%); however, the mean values between the 3 groups were not significantly different. The mean cough transmission pressures were significantly higher among chronic coughers than non-chronic coughers. When controlled for chronic coughing, the stress incontinent respondents have a significantly higher bladder pressure than continent and non-stress incontinent respondents. Significance of these findings in relation to the mechanisms of female geriatric incontinence are presented.