Continence physiology and pathology in females: theoretical and practical clinical aspects

Report is dedicated to review of scientific researches of female stress continence mechanism made in research institute named after D.O. Ott for last forty years. Basing on own researches, assimilating innovative ideas of other researchers, which were working on this problem at the same time, authors present own synthetic conception of female continence in physiological and pathological conditions as a multiple-factor, multiunit system, interaction of every factor of which has mutual connections and mutual dependencies. The mentioned synthetic conception, due to its authors opinion, supposed to become certain counterbalance to process of primitivization of female stress continence mechanism. Simplification of these ideas, as it happened more than once in history of urogynecology, is a consequence of utilitarian approach to challenges in female stress incontinence management. Anatomy and physiology of female urethra was described in details, with characterization of continence mechanism. Urethral locking mechanism, morphological and functional particularities of urethra, biomechanical substrate of segment force architecture of urethra were observed. It was shown that huge system of neural and muscular interactions participates in voiding act to level and inverse of urethrovesical pressure gradient.