{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:29:55Z","timestamp":1791397795555,"version":"4.3.3"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,7,5]],"date-time":"2012-07-05T00:00:00Z","timestamp":1341446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Stress urinary incontinence (SUI) is a common health problem in women. Reflex activation of muscular pelvic floor structures may play a role in preserving continence. In this study we aimed to analyze reflex pelvic floor activity on coughing in women seen for urodynamic testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a retrospective cohort study we analyzed the data sets of 191 women who attended a tertiary referral service for multichannel urodynamic testing and four\u2010dimensional pelvic floor ultrasound scan between May 2009 and February 2010. Coughs were registered on volume ultrasound at a minimum of 16 Hz and analyzed by postprocessing at a later date, the operator being blinded against all clinical data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 175 analyzable cough volume datasets, a levator reflex was seen in 138 (79%), and clitoral reflex movement in 160 (91%). On multivariable analysis there was a significant relationship between urodynamic stress incontinence (USI) and the absence of a levator reflex (<jats:italic>P<\/jats:italic> = 0.045), and a negative relationship with the magnitude of such a reflex (<jats:italic>P<\/jats:italic> = 0.046). Reflex timing was not associated with SUI or USI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reflex contraction of the levator ani can be observed on translabial ultrasound during sudden increases in intra\u2010abdominal pressure. These reflex contractions are common, even in women with symptoms and signs of pelvic floor dysfunction. The observation of a levator reflex on coughing, and its magnitude, show a weak inverse association with the presence of USI. Copyright \u00a9 2012 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.11087","type":"journal-article","created":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T07:21:41Z","timestamp":1325834501000},"page":"215-218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Reflex contraction of the levator ani in women symptomatic for pelvic floor disorders"],"prefix":"10.1002","volume":"40","author":[{"given":"H. P.","family":"Dietz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Erdmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. L.","family":"Shek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,7,5]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001920070021"},{"key":"e_1_2_6_3_2","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1080\/00365590151030804-1","article-title":"Some biomechanical aspects of continence function","volume":"207","author":"Schaefer W","year":"2001","journal-title":"Scand J Urol Nephrol"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7658"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001920200063"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.01.098"},{"key":"e_1_2_6_7_2","first-page":"423","volume-title":"Incontinence","author":"Mostwin J","year":"2005"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.06.011"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10083"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00819.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-009-0882-1"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1072"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3951"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6403"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1329-4"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6268"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1899"},{"key":"e_1_2_6_18_2","first-page":"392","article-title":"The Knack: Use of precisely timed pelvic floor muscle contraction can reduce leakage in SUI","volume":"15","author":"Miller J","year":"1996","journal-title":"Neurourol Urodyn"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200102000-00017"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.07.023"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-012-1705-3"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01751.x"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.02.005"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8969"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-007-0491-9"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000250901.57095.ba"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.11087","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.11087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T08:48:52Z","timestamp":1696668532000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.11087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7,5]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1002\/uog.11087"],"URL":"https:\/\/doi.org\/10.1002\/uog.11087","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,7,5]]},"assertion":[{"value":"2011-12-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-07-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}