Abstract
Objective: The purpose of this study was to evaluate the relationship between levator ani contraction
and motor unit action potential activation in the striated urethral sphincter. Study Design: One hundred eight women who underwent preoperative evaluation at our referral center
were studied. All women gave a urogynecologic history and underwent physical examination,
multichannel urodynamic testing, and urethral sphincter electromyography. Manual muscle
testing was used to grade levator ani contractions as poor, moderate, or strong; quantitative
electromyography software was used to analyze motor unit action potential activation
in the urethral sphincter. Results: Levator ani contractions were graded as poor in 46% of the women, moderate in 31%
of the women, and strong in 23% of the women. Manual muscle grade was not related
to quantitative electromyography values in the urethral sphincter at rest or with
voluntary pelvic floor contraction. Poor manual muscle grade was associated with detrusor
instability (P =.004) and more advanced stages of prolapse (P =.037). Levator ani strength was not significantly related to age, genuine stress
incontinence, urethrovesical junction hypermobility, menopausal status, or surgical
cure rates. Conclusion: The ability to contract the levator ani does not appear to be related to the ability
to activate motor unit action potentials in the urethral sphincter, which suggests
that the function of the levator ani in maintaining urinary continence is independent
from the role of the urethral sphincter. (Am J Obstet Gynecol 2002;187:403-6.)
Keywords
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Article info
Publication history
Accepted:
February 13,
2002
Received:
October 4,
2001
Footnotes
☆Reprints not available from the authors.
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
