Connective tissue in female urinary incontinence

An effective closure of the female urethra in stress situations is dependen t on an integrated action of various anatomical structures connected to the organ. The most important of these structures - from a functional aspect - are the suburethral vaginal wall, the pubourethral ligaments, the pubococc ygeus muscles and the paraurethral connective tissues. In all these structu res connective tissue is an essential ingredient. Hence, defects in the act ual connective tissue - in particular the paraurethral connective tissue th at connects the aforementioned structures to each other and to the urethra - will bring about an ineffective urethral closure. Female urinary incontin ence may then be caused by defective connective tissue per se and/or by a d isconnection of the aforementioned structures, whereby the urethra cannot b e 'kinked' - that is, closed off in stress situations. Curr Opin Obstet Gyn ecol 11:509-515. (C) 1999 Lippincott Williams & Wilkins.