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At the Gynaecological Department of the University of Innsbruck, 207 nipple stimulation for the induction of uterine contractions were performed, using the necessary precautions, in 186 pregnant women at term. The continuous or intermittent manual stimulation by the patient was mainly used for contraction stress testing. An adequate uterine response (at least 3 contractions per 10 minutes) was achieved in 57%. Reversible signs of hyperstimulation, such as prolonged uterine contractions and tachysystoles, were observed in 10%, causing reversible pathologic fetal heart rate patterns in 1%. The classical intravenous oxytocin challenge test produced a higher uterine response rate as compared at the same time to breast stimulation. Provided, that an adequate response was achieved, normal and pathological fetal reaction patterns were identical in both tests. In 20 patients we used nipple electrostimulation. Results were similar to those achieved by manual stimulation. Due to the conflicting reports in the literature and because of the potential hazards involved, the use of nipple stimulation for the induction of uterine contractions can be advocated only in a controlled clinical setting. Its application without medical supervision, as propagated in the lay press, is definitely contraindicated.

We compared two groups of patients 14 months after vaginal hysterectomy and pelvic floor repair, group I (n = 20) postoperatively continent versus group II (n = 27) postoperatively incontinent. Preoperative urodynamic findings were of no prognostic value with regard to continence. There was no statistical difference in maximum resting urethral closure pressure (UCP), urethral functional length and dynamic and reflectoric vesico-urethral transmission factor, in spite of group I having a slightly higher resting UCP than group II. Group II showed a significant decrease of resting UCP postoperatively.