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