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. 2000 May;95(5):713-7.
doi: 10.1016/s0029-7844(00)00786-9.

Racial differences in the structure and function of the stress urinary continence mechanism

D Howard  1 , J O Delancey, R Tunn, J A Ashton-Miller
Affiliations

Racial differences in the structure and function of the stress urinary continence mechanism

D Howard et al. Obstet Gynecol. 2000 May.

Abstract

Objective: To compare the structure and function of the urethral sphincter and the urethral support in nulliparous black and white women.

Methods: Eighteen black women (mean age 28.1 years) and 17 white women (mean age 31.3 years) completed this cross-sectional study. The following assessments were made: urethral function using multichannel cystometrics and urethral pressure profilometry, pelvic muscle strength using an instrumented speculum, urethral mobility using the cotton-swab test and perineal ultrasound, and pelvic muscle bulk using magnetic resonance imaging.

Results: Black women demonstrated a 29% higher average urethral closure pressure during a maximum pelvic muscle contraction (154 cm H(2)O versus 119 cm H(2)O in the white subjects; P =.008). Although not statistically significant, black women had a 14% higher maximum urethral closure pressure at rest (108 cm H(2)O versus 95 cm H(2)O; P =.23) and a 21% larger urethral volume (4818 mm(3) versus 3977 mm(3); P =.06). In addition, there was a 36% greater vesical neck mobility measured with the cotton-swab test (blacks 49 degrees versus whites 36 degrees; P =.02) and a 42% difference in ultrasonically measured vesical neck mobility during a maximum Valsalva effort (blacks = -17 mm versus whites -12 mm; P =.08).

Conclusion: Functional and morphologic differences exist in the urethral sphincteric and support system of nulliparous black and white women.

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Figures

Figure 1
Figure 1
Vesical neck movement as measured in relation to the symphysis. D (dark arrow) shows the total distance the vesical neck moved from rest to its location at peak Valsalva pressure.
Figure 2
Figure 2
Mean resting urethral closure pressure of both groups and amount of pressure increase achieved during a maximum pelvic muscle contraction, with standard deviations.
See this image and copyright information in PMC

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