Micturition

1. Front Matter

   Pages i-xiv

   PDF

2. Basic Science

   1. Front Matter

      Pages 1-1

      PDF

   2. Anatomy of the Urethral Sphincters and Supports

      • J. O. L. DeLancey

      Pages 3-16

   3. Innervation of the Bladder, Urethra and Pelvic Floor

      • M. Swash

      Pages 17-27

   4. Neurotransmitters and Receptor Functions in the Human Lower Urinary Tract

      • K.-E. Andersson

      Pages 29-39

   5. Continence Mechanism

      • S. Kulseng-Hanssen, B. Klevmark

      Pages 41-55

3. Investigation

   1. Front Matter

      Pages 57-57

      PDF

   2. Application of Animal and Physical Models to Human Cystometry

      • R. van Mastrigt

      Pages 59-79

   3. Relevance of Urethral Pressure Profilometry To Date

      • E. Versi

      Pages 81-109

   4. Urethral Electric Conductance

      • S. Plevnik

      Pages 111-127

   5. Vaginal Ultrasound and Urinary Stress Incontinence

      • M. J. Quinn

      Pages 129-141

   6. Role of Electrophysiological Studies

      • R. S. Kirby, I. Eardley

      Pages 143-160

4. Voiding Difficulties

   1. Front Matter

      Pages 161-161

      PDF

   2. Pathophysiology of Voiding Disorders

      • P. J. R. Shah

      Pages 163-173

   3. Medical and Surgical Management of Female Voiding Difficulty

      • K. Murray

      Pages 175-199

5. Genuine Stress Incontinence

   1. Front Matter

      Pages 201-201

      PDF

   2. Pathophysiology of Genuine Stress Incontinence

      • D. W. Warrell

      Pages 203-208

   3. Conservative Management

      • A. M. Shepherd

      Pages 209-224

   4. Which Operation and for Which Patient?

      • P. Hilton

      Pages 225-246

   5. Why Operations Fail

      • S. L. Stanton

      Pages 247-267

Urinary incontinence is a humiliating disability and a common problem in gynaecological clinics. In some centres specialised facilities are avail­ able for its investigation and treatment but in most hospitals the general gynaecologist has to manage this difficult condition. For both generalist and subspecialist it is timely to summarise advances in our knowledge of normal and abnormal micturition. Since 1973 the Royal College of Obstetrician's and Gynaecologists, through its Scientific Advisory Committee, has convened Study Groups on important growth areas in our specialty. The College invites an international panel of leading researchers to participate in a workshop, allowing time for in-depth discussion as well as the presentation of papers. It is hoped that this will produce not only an up-to-date sum­ mary of current knowledge but also a useful interaction between indi­ viduals and between specialties. This book is the result of the 21st Study Group, which was held in October 1989. The participants included urological and colorectal surgeons and a neurologist, as well as scientists and gynaecologists. The meeting began with sessions on basic science and advances in the investigation of the lower urinary tract, then covered voiding diffi­ culties, genuine stress incontinence and detrusor instability, before a final session on the relationship between urinary incontinence and ali­ mentary tract problems. The discussions formed an essential part of the meeting, and it is hoped that the lightly edited versions reproduced here will convey to the reader the stimulating atmosphere of the Study Group.

• gynecology
• incontinence
• physiology

• Department of Obstetrics and Gynaecology, Clinical Sciences Building, Leicester Royal Infirmary, UK

  James O. Drife

• Department of Obstetrics and Gynaecology, University of Newcastle upon Tyne, Princess Mary Maternity Hospital, Newcastle upon Tyne, UK

  Paul Hilton

• Urodynamic Unit, Department of Obstetrics and Gynaecology, St George’s Hospital Medical School, Cranmer Terrace, London, UK

  Stuart L. Stanton

Policies and ethics