Pelvic floor muscle contraction during a cough and decreased vesical neck mobility
Open accessAbstract
OBJECTIVE: To test the hypothesis that a voluntary pelvic muscle contraction initiated in preparation for a cough, a maneuver we call the Knack, significantly reduces vesical neck displacement. METHODS: A convenience sample of 22 women consisted of 11 young, continent nulliparas (mean age [+/- standard deviation] 24.8 +/- 7.0 years) and 11 older, incontinent paras (mean age [+/-SD] 66.9 +/- 3.9 years). With the use of perineal ultrasound, we quantified vesical neck displacement at rest and during coughs using caliper tracing and a coordinate system. The subjects coughed with and without voluntary pelvic floor muscle contraction. RESULTS: Vesical neck mobility during coughs was significantly decreased when voluntary contraction was used: from a median (range) of 5.4 (20.0) mm without volitional contraction to 2.9 (18.3) mm with volitional contraction (P <.001). The younger women demonstrated a median (range) decrease in excursion from 4.6 (19.5) to 0.0 (17.0) mm (P =.007), and the older incontinent women demonstrated a median (range) decrease from 6.2 (10.0) to 3.5 (15.4) mm (P =.003). At rest, the median vesical neck position in the group of older incontinent women was significantly further dorsocaudal (P =.001) than in the younger women. CONCLUSION: A pelvic floor muscle contraction in preparation for, and throughout, a cough can augment proximal urethra support during stress, thereby reducing the amount of dorsocaudal displacement.
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A voluntary contraction of the pelvic floor muscles constricts the levator hiatus, elevates and stabilizes the pelvic floor into a higher position.
“a voluntary contraction of the PFM constricts the levator hiatus, elevates and stabilizes the pelvic floor into a higher position.”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [23]
Cites
STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
Martin Bland, J., & Altman, D. (1986) · The Lancet · doi:10.1016/s0140-6736(86)90837-8 · Cited by 47,965 · see citing works
Beckett, A. H., Rowland, M., & TURNER, P. (1965) · The Lancet · doi:10.1016/s0140-6736(65)91037-8 · Cited by 16,917 · see citing works
Measurement in Medicine: The Analysis of Method Comparison Studies
Altman, D. G., & Bland, J. M. (1983) · The Statistician · doi:10.2307/2987937 · Cited by 4,300 · see citing works
Muscle stiffness in human ankle dorsiflexors: intrinsic and reflex components
Sinkjær, T., Toft, E. S., Andreassen, S., & Hornemann, B. C. (1988) · Journal of Neurophysiology · doi:10.1152/jn.1988.60.3.1110 · Cited by 425 · see citing works
A Pelvic Muscle Precontraction Can Reduce Cough‐Related Urine Loss in Selected Women with Mild SUI
Miller, J. M., Ashton‐Miller, J. A., & DeLancey, J. O. L. (1998) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1998.tb02721.x · Cited by 392 · see citing works
Self-citationComparing Two Methods of Clinical Measurement: A Personal History
Bland, J. M., & Altman, D. G. (1995) · International Journal of Epidemiology · doi:10.1093/ije/24.supplement_1.s7 · Cited by 297 · see citing works
Perineal ultrasound for evaluating the bladder neck in urinary stress incontinence
Schaer, G. N., Koechli, O. R., Schuessler, B., & Haller, U. (1995) · Obstetrics and Gynecology · doi:10.1016/0029-7844(94)00369-o · Cited by 271 · see citing works
The urinary diary in evaluation of incontinent women: a test-retest analysis.
Wyman, J. F., Choi, S.-W., Harkins, S. W., et al. (1988) · PubMed · Cited by 253 · see citing works
Observations on Stress Incontinence of Urine
Jeffcoate, T. N. A., & Roberts, H. (1952) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(16)38792-0 · Cited by 182 · see citing works
Outcome measures for research in adult women with symptoms of lower urinary tract dysfunction
Lose, G., Fantl, J. A., Victor, A., Walter, S., Wells, T. L., Wyman, J. F., & Mattiasson, A. (1998) · Neurourology and Urodynamics · doi:10.1002/(sici)1520-6777(1998)17:3 · Cited by 164 · see citing works
Relationships of the female urethra and bladder in urinary stress incontinence
Hodgkinson, C. P. (1953) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(83)90612-9 · Cited by 122 · see citing works
Taverner, D., & Smiddy, F. G. (1959) · Diseases of the Colon & Rectum · doi:10.1007/bf02616708 · Cited by 113 · see citing works
Bø, K., Kvarstein, B., Hagen, R., & Larsen, S. E. (1990) · Neurourology and Urodynamics · doi:10.1002/nau.1930090503 · Cited by 112 · see citing works
Perineal ultrasound: determination of reliable examination procedures
Schaer, G. N., Koechli, O. R., Schuessler, B., et al. (1996) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.1469-0705.1996.07050347.x · Cited by 79 · see citing works
The Difference in Stiffness of the Active Plantarflexors Between Young and Elderly Human Females
BLANPIED, P. R., & Smidt, G. L. (1993) · Journal of Gerontology · doi:10.1093/geronj/48.2.m58 · Cited by 76 · see citing works
Wijma, J., Tinga, D. J., & Visser, G. H. A. (2010) · Gynecologic and Obstetric Investigation · doi:10.1159/000293024 · Cited by 55 · see citing works
Levator ani muscle morphology and recurrent genuine stress incontinence
Hanzal, E., BERGER, E., & Koelbl, H. (1993) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(93)90360-9 · Cited by 53 · see citing works
Quantification of Cough-Related Urine Loss Using the Paper Towel Test
Miller, J. M., ASHTON-MILLER, J. A., & DELANCEY, J. O. L. (1998) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(98)00045-3 · Cited by 46 · see citing works
Self-citationFunctional Anatomy of the Pelvic Floor and Lower Urinary Tract
Perucchini, D., & DeLancey, J. O. (2008) · Springer eBooks · doi:10.1007/978-1-84628-505-9_1 · Cited by 46 · see citing works
Versi, E. (1998) · Journal of the Society for Gynecologic Investigation · doi:10.1016/s1071-5576(98)00038-0 · Cited by 40 · see citing works
Neurobiology of Incontinence (Ciba Foundation Symposium 151)
Mitsumato, H. (1991) · Neurology · doi:10.1212/wnl.41.12.2016-b · Cited by 36 · see citing works
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B�, K. (2004) · International Urogynecology Journal and Pelvic Floor Dysfunction · doi:10.1007/s00192-004-1125-0 · Cited by 480 · see citing works
Brækken, I. H., Majida, M., Engh, M. E., & Bø, K. (2010) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.02.037 · Cited by 241 · see citing works
Bø, K., Sherburn, M., & Allen, T. (2003) · Neurourology and Urodynamics · doi:10.1002/nau.10139 · Cited by 149 · see citing works
Physiotherapy management of urinary incontinence in females
Bø, K. (2020) · Journal of Physiotherapy · doi:10.1016/j.jphys.2020.06.011 · Cited by 80 · see citing works
Brækken, I. H., Majida, M., Ellström Engh, M., & Bø, K. (2015) · The Journal of Sexual Medicine · doi:10.1111/jsm.12746 · Cited by 75 · see citing works
Bø, K., Anglès-Acedo, S., Batra, A., Brækken, I. H., Chan, Y. L., Jorge, C. H., Kruger, J., Yadav, M., & Dumoulin, C. (2022) · International Urogynecology Journal · doi:10.1007/s00192-022-05324-0 · Cited by 64 · see citing works
“This results in an immediate effect during the PFM contraction of lifting the bladder neck and stabilizing the pelvic floor [23, 24].”
Background
- Authors
- Miller, J.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Miller, J
- ORCID
- Miller, J
- Venue
- Obstetrics & Gynecology
- Published
- 2001-02
- Volume
- 97
- Issue
- 2
- Pages
- 255-260
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC1226460
- OpenAlex
- W2031798880
- Cited by
- 147
- References
- 21
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 4 · 2020: 7 · 2019: 12 · 2018: 7 · 2017: 4 · 2015: 9 · 2014: 12 · 2013: 3 · 2012: 6
- FWCI
- 3.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01dk047516-03, 1p30ag008808-01)
- National Institute on Aging (P60AG008808, P30 AG08808, T32 AG-00114, T32AG000114)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK051405, R01 DK51405, R01 DK 47516)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD047516)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- pelvic floor muscle contraction, cough, stress urinary incontinence, transperineal ultrasound, nulliparous women, postpartum women, age differences
- MeSH terms
- Adult, Aged, Urinary Bladder, Cough, Female, Humans, Isometric Contraction, Middle Aged, Reference Values, Urinary Incontinence, Stress, Urodynamics, Pelvic Floor
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