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Six continent and 4 incontinent females were examined by a combined technique of simultaneous urethrocystometry and rapid X-ray-film exposures. The study confirmed that pressure changes occurring in the urethra and bladder at initiation of voiding were not caused by artefacts of the measuring technique. It was found that the continent females initiated micturition mainly by a rapid decrease in urethral pressure followed by an increase in the bladder pressure. The stress incontinent females strained out the urine without initial urethral relaxation. Since the X-ray-technique did not add any new clinical information about micturition in females the pressure recording technique is recommended for routine investigation of micturition in females.

Sixteen healthy women, and 13 with stress incontinence were investigated by simultaneous urethrocystometry during the initiation of voiding. In the healthy women, there was a decrease in the maximum intra-urethral pressure immediately before micturition. A few seconds later (mean 3.0 sec), the intravesical pressure increased. As a result, the urethral closure pressure decreased to zero, and urine started to escape from the urethra. In the patients with stress in continence, three different ways of initiating micturition were observed. Five patients initiated voiding by the Valsalva manoeuvre, 3 mainly by decreasing the maximum urthral pressure, and 5 mainly in the same way as the healthy women. The results suggest that preoperative analysis of the micturition pattern by means of simultaneous urethrocystometry can be of value for the choice of operative procedure, and thereby make it possible to avoid or reduce postoperative retention of urine.