What causes stress incontinence: Fallacies, fascias and facts

摘要

The traditional view of the pathophysiology of stress urinary incontinence (SUI) was that a loss of urethral support was the primary abnormality present. Recent research has challenged this hypothesis, demonstrating that impaired urethral function plays the key causative role. Improving our understanding of the underlying pathologic mechanisms is important to identifying the cause of treatment failures and for developing novel therapies to treat SUI. Over the last century, several hypotheses have been proposed to explain the pathophysiology of stress urinary incontinence (SUI). These theories have largely been based on uncontrolled clinical observations or comparing women with stress incontinence to women undergoing urodynamics that did not have stress incontinence (i.e., urge incontinence), focusing on loss of urethral support and an open vesical neck as the primary causative abnormalities. This traditional view of SUI causation has, however, been challenged by recent research investigating the potential role of urethral function in SUI using asymptomatic volunteers for comparison.