Het afsluitmechanisme van de urethra bij de vrouw tijdens fysieke stress en de consequenties voor de urologische en urogynaecologische praktijk

The closure of the urethra in females under condition of stress is the result of a reflex contraction of the urethral rhabdosphincter and pelvic floor muscles. This is likely induced by activity of the abdominal muscles due to a sudden increase in abdominal pressure. This reflex contraction with increase of urethral pressure occurs a few milliseconds before an increase in intra-abdominal pressure. The urethral pressure increase during stress is only possible with fixation of the urethra by the pubourethral ligaments (PUL), facilitating urethral kinking. The highest and most important increase in pressure and resistance, occurs in the distal urethra due to this kinking of the urethra.