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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The urethral sphincter is situated at the region of the bladder neck and proximal two-thirds of the urethra. It contributes about 50% of the total urethral resistance.

Stress urinary incontinence occurs when the proximal urethra drops below the pelvic floor because of pelvic relaxation defects. Intra-abdominal pressure is no longer transmitted equally to the bladder and proximal urethra.

This situation is most frequent:

  • following childbirth - pregnancy, labour and delivery may all cause mechanical and denervation injury to the normal supports of the bladder neck and proximal urethra
  • after the menopause - decreased intraurethral pressure due to oestrogen lack

Imperfect sphincter control also complicates epispadias which show a widened bladder neck, shortened urethra and separation of the symphysis pubis.

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