Department of Urology, Maastricht UMC, Maastricht, The Netherlands.
Neurourol Urodyn. 2024 Sep;43(7):1647-1654. doi: 10.1002/nau.25489. Epub 2024 May 22.
The closure of the urethra under the 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 an increase of urethral pressure occurs a few milliseconds before an increase in intraabdominal 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.
在应激状态下，尿道关闭是尿道横纹肌和盆底肌反射性收缩的结果。这可能是由于腹部肌肉活动导致腹内压突然增加引起的。这种反射性收缩伴随着尿道压力的增加，发生在腹内压增加的几毫秒之前。只有在耻骨尿道韧带（PUL）固定尿道的情况下，尿道才会发生这种扭曲，从而导致尿道压力升高，这一反射性收缩才会导致尿道压力升高。在应激状态下，尿道压力的增加仅在尿道被耻骨尿道韧带（PUL）固定时才有可能，这有利于尿道的扭曲。由于这种尿道扭曲，尿道的远端会出现最高和最重要的压力和阻力增加。
