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Micturition pp 209–224Cite as

Conservative Management

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Abstract

When urinary incontinence is due to pelvic floor dysfunction or urethral sphincter incompetence conservative management involving re-education of the pelvic floor muscles is recognised by many to be one of the methods of regaining continence. The precise alteration in the normal mechanism which causes genuine stress incontinence has not been defined and thus it is difficult to understand the exact mode by which this treatment is effective. The pubococcygeus portion of the levator ani is most closely related to the urethra and the muscle fibres interdigitate, inserting into the lateral walls of the vagina. Because of their proximity to the urethra it is probable that contraction of these fibres increases urethral closure pressure as well as causing an appreciable contraction which can be felt within the vagina. Both slow- and fast-twitch muscle fibres are present giving the muscle the unusual dual role of constant postural tone provided by the slow-twitch fibres, with the fast-twitch fibres being recruited in response to a sudden increase in abdominal pressure on coughing or sneezing.

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Authors
  1. A. M. Shepherd
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Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynaecology, Clinical Sciences Building, Leicester Royal Infirmary, LE2 7LX, UK

    James O. Drife FRCS, MRCOG (Consultant Obstetrician and Gynaecologist) (Consultant Obstetrician and Gynaecologist)

  2. Department of Obstetrics and Gynaecology, University of Newcastle upon Tyne, Princess Mary Maternity Hospital, Great North Road, NE2 3BD, Newcastle upon Tyne, UK

    Paul Hilton MD, BS, MRCOG (Senior Lecturer) (Senior Lecturer)

  3. Urodynamic Unit, Department of Obstetrics and Gynaecology, St George’s Hospital Medical School, Cranmer Terrace, SW17 0RE, London, UK

    Stuart L. Stanton FRCS, FRCOG (Consultant Obstetrician and Gynaecologist) (Consultant Obstetrician and Gynaecologist)

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© 1990 Royal College of Obstetricians and Gynaecologists

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Shepherd, A.M. (1990). Conservative Management. In: Drife, J.O., Hilton, P., Stanton, S.L. (eds) Micturition. Springer, London. https://doi.org/10.1007/978-1-4471-1780-3_13

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  • DOI: https://doi.org/10.1007/978-1-4471-1780-3_13

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1782-7

  • Online ISBN: 978-1-4471-1780-3

  • eBook Packages: Springer Book Archive

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