The Anatomical Pathogenesis of Stress Urinary Incontinence in Women

Abstract

Stress urinary incontinence is a common disease in middle-aged and elderly women, which seriously affects the physical and mental health of the patients. For this reason, researchers have carried out a large number of studies on stress urinary incontinence. At present, it is believed that the pathogenesis of the disease is mainly due to changes related to age, childbirth, obesity, constipation and other risk factors that induce changes in the urinary control anatomy, including the anatomical factors of the urethra itself, the anatomical factors around the urethra and the anatomical factors of the pelvic nerve. The combined actions of a variety of factors lead to the occurrence of stress urinary incontinence. This review aims to summarize the anatomical pathogenesis of stress urinary incontinence from the above three perspectives.

Association between Systemic Immune-Inflammation Index and stress urinary incontinence in adult women: a population-based study

“…Li et al 11 reported that urinary tract infection and gynaecological in ammation can worsen the symptoms of SUI among 1178 Chinese women. Furthermore, Aldridge et al 29 found that 62% of patients with SUI had chronic urethritis, as evidenced by urethroscopy and cystometrization of 279 patients. In chronic urethritis, prolonged in ammatory stimulation leads to brosis of the urethral mucosa, diminished mucus secretion, and decreased submucosal vascularity 29 .…”

“…Furthermore, Aldridge et al 29 found that 62% of patients with SUI had chronic urethritis, as evidenced by urethroscopy and cystometrization of 279 patients. In chronic urethritis, prolonged in ammatory stimulation leads to brosis of the urethral mucosa, diminished mucus secretion, and decreased submucosal vascularity 29 . Such changes compromise the urethral mucosa's sealing effect, thereby increasing the likelihood of SUI.…”

Age-Related Changes in Urethral Structure and Responds to Injury: Single-Cell Atlas of a Rat Model of Vaginal Birth Injury induced Stress Urinary Incontinence

“…We postulate that senescence of urothelium which hinders the repair after uerthral injury, may be one of the reasons of incomplete recovery of continence in older female. The urethral epithelium is an important part of the urethral mucosa, which produces mucoid secretions and exerts a valve seat and O-ring like sealing effect in a water faucet with the assistance of submucosal blood vessels 10 . We found that the superficial and intermediate urothelium of the middle-age rats were damaged and shed, leading to the destruction of its barrier structure.…”

“…Pelvic floor and urethral striated muscle were regarded as the most important functional cell type in producing and maintaining urethral pressure. In addition, weakened sealing effect of the urethral mucosa, decreased elasticity of the urethral wall and shortened length of the functional urethra together also led to the occurrence of urinary incontinence 10 .…”

Treatment of Moderate and Severe Pelvic Organ Prolapse by Biomechanical Reconstruction: A Series of 135 patients

“…SUI occurs due to a stress injury to the pelvic oor, resulting in reduced support of the bladder neck, mid and posterior urethra by the levator ani muscle (LAM), and perineal body (PB) (5). When abdominal pressure increases, the posterior bladder wall and bladder neck lose support and shift backwards, leading to poor bladder neck closure, a shortened functional urethra and reduced hydrostatic pressure in the urethra, which induces SUI(6).…”