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• W2000449801 abstract "The physiology of urinary continence is complex and the respective role of active and passive mechanisms is still subject to debate. Many different sacral reflexes are involved in these processes. The present literature review focuses on the neuromuscular mechanisms, which are involved in the pathophysiology of female stress urinary incontinence (SUI). We performed a systematic review of the literature in the Medline, Pascal and Embase databases by using the following keywords: reflex, perineal, sacral, urethral pressure, urethra, pelvic floor, fatigue, continence, incontinence and muscle. In recent years, new pathophysiological hypotheses concerning abnormal pelvic floor muscle reflex responses to stress have been discussed and included an abnormal time course of pelvic floor muscle activation during coughing. It has also been suggested that unusually rapid fatigue of the pelvic floor muscle reflex may be involved in some women. Overall, there are arguments in favour of the involvement of neuromuscular dysfunction in the pathophysiology of female SUI – particularly dysfunctional and delayed pelvic floor muscle reflex responses during coughing. It would be useful to establish whether these neuromuscular dysfunctions may be remedied by physiotherapeutic pelvic floor muscle training. La physiologie de la continence urinaire à l’effort est complexe et les rôles respectifs des mécanismes actifs et passifs mis en jeu demeurent mal connus. De nombreux réflexes périnéaux sont impliqués dans cette continence. Cette revue de la littérature se focalise sur les mécanismes neuromusculaires réflexes impliqués dans la physiopathologie de l’incontinence urinaire à l’effort de la femme. Revue systématique de la littérature à partir des bases de données Medline, Pascal et Embase en utilisant les mots clés : réflexe, périnéal, sacré, fatigue, continence, incontinence, plancher pelvien, urètre, pression urétrale, muscle… Depuis quelques années, de nouvelles hypothèses physiopathologiques sont évoquées impliquant des anomalies de la réponse réflexe de la musculature pelvipérinéale dont des anomalies de la cinétique d’activation des muscles pelvipérinéaux lors de la toux. De plus, il pourrait également exister une fatigabilité excessive de la réponse réflexe périnéale chez certaines femmes. Au total, il existe des arguments en faveur de la participation de dysfonctionnements neuromusculaires dans la physiopathologie de l’incontinence urinaire à l’effort de la femme, en particulier un défaut et un retard d’activation de la musculature du plancher pelvien lors de la toux. Il serait intéressant d’étudier si ces dysfonctionnements neuromusculaires sont réversibles par la rééducation périnéosphinctérienne." @default.
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• W2000449801 date "2009-04-01" @default.
• W2000449801 modified "2023-10-16" @default.
• W2000449801 title "Sacral reflexes and urinary incontinence in women: New concepts" @default.
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• W2000449801 doi "https://doi.org/10.1016/j.rehab.2008.12.013" @default.
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