Racial Differences Found in Urethral Closure Pressure


HOLLYWOOD, FLA. — A cohort of 91 continent black women had a 22% higher maximal urethral closure pressure (mean 68.0 cm H2O) than a group of 46 continent white women (55.8 cm H2O) in a study.

Dr. John O. DeLancey and his colleagues previously assessed 335 community-dwelling women both with and without urge and stress urinary incontinence. They found the prevalence of urinary incontinence was 15% for black women and 33% for white women (J. Urol. 2008;179:1455-60).

The only other difference between groups was that 39% of white women with incontinence reported pure stress incontinence symptoms, compared with 25% of black women. In contrast, 24% of black women reported pure urge incontinence symptoms, compared with 11% of white women.

So they decided to search further. They conducted urethral pressure profilometry, the Q-tips test, a cystometrogram, Pelvic Organ Prolapse Quantification, and a vaginal closure force test for each of the 335 participants. The National Institutes of Health sponsored the research.

The white cohort consisted of 46 continent women, 55 with stress urinary incontinence, and 44 with urge urinary incontinence. The black cohort was composed of 91 continent women, 47 with stress urinary incontinence, and 52 with urge urinary incontinence. The inclusion of continent women was a strength of the study, Dr. DeLancey said at the annual meeting of the American Urogynecologic Society.

They found no significant differences between black and white women in terms of the Q-tips test results at rest or during a Kegel contraction or Valsalva maneuver. In addition, there were no significant differences between groups in ureterovaginal support on physical examination or the vaginal closure force test at rest or with contraction.

“When we asked women to perform a Kegel contraction, urge incontinent white women were less able to contract than stress incontinent white women,” said Dr. DeLancey, professor of obstetrics and gynecology and director of the Pelvic Floor Research Group at the University of Michigan in Ann Arbor. This difference was not found among black women.

In addition to overall differences in maximal urethral closure pressures (MUCPs) by race, they found some subgroup differences as well. For example, continent white women had 19% higher MUCPs than white women with either stress or urinary urge incontinence. Among white women, the group with urge urinary incontinence had the lowest increases in urethral closure pressure during muscle contraction, 45% lower than continent women and 43% lower than those with stress incontinence.

Disclosures: None was reported.

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