{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:06:25Z","timestamp":1784552785056,"version":"3.55.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and Hypothesis<\/jats:title>\n                    <jats:p>The pathophysiology of female urinary incontinence (UI) is often considered complex and poorly understood, partly due to the limitations of prevailing theories such as the integral theory and the hammock theory, both of which contradict established physical laws. This article introduces the urethral hanging theory (UHT) as a unified biomechanical model that explains stress urinary incontinence (SUI), mixed urinary incontinence (MUI), intrinsic sphincter deficiency (ISD), and idiopathic urge urinary incontinence (UUI) as a continuum of funneling-related pathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Anatomical analysis, physical principles, published work by others, clinical experience, and mental simulations were used to develop the model. The UHT attributes symptoms to differential mobility\u2014a mechanical imbalance\u2014between the urethra and the bladder neck, resulting in varying degrees of funneling during physical strain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The theory provides a physically consistent framework that explains symptom variation across different types of UI and unifies them with a single biomechanical continuum. This framework also offers guidance for individualized surgical interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>If validated clinically, the UHT could substantially improve diagnostic precision and treatment outcomes for female urinary incontinence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-025-06391-9","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T08:32:14Z","timestamp":1764405134000},"page":"1929-1933","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Urethral Hanging Theory: A Unified Biomechanical Model for the Pathophysiology and Treatment of\u00a0Female Urinary Incontinence"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1593-7811","authenticated-orcid":false,"given":"Bo S.","family":"Bergstr\u00f6m","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"6391_CR1","doi-asserted-by":"publisher","first-page":"2066","DOI":"10.1056\/NEJMoa0912658","volume":"362","author":"HE Richter","year":"2010","unstructured":"Richter HE, Albo ME, Zyczynski HM, et al. Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med. 2010;362:2066\u201376.","journal-title":"N Engl J Med."},{"issue":"3","key":"6391_CR2","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1002\/nau.23018","volume":"36","author":"BS Bergstr\u00f6m","year":"2017","unstructured":"Bergstr\u00f6m BS. Urethral hanging theory. Neurourol Urodyn. 2017;36(3):826\u20137.","journal-title":"Neurourol Urodyn."},{"issue":"3","key":"6391_CR3","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s00192-021-05024-1","volume":"33","author":"BS Bergstr\u00f6m","year":"2022","unstructured":"Bergstr\u00f6m BS. Stress urinary incontinence is caused predominantly by urethral support failure. 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Dynamic magnetic resonance imaging of the behavior of the mid-urethra in healthy and stress incontinent women. Obstet Gynecol Surv. 2010;65(6):371\u20132.","journal-title":"Obstet Gynecol Surv."},{"key":"6391_CR12","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1002\/uog.7658","volume":"36","author":"A Pirpiris","year":"2010","unstructured":"Pirpiris A, Shek KL, Dietz HP. Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol. 2010;36:507\u201311. https:\/\/doi.org\/10.1002\/uog.7658.","journal-title":"Ultrasound Obstet Gynecol."},{"key":"6391_CR13","doi-asserted-by":"crossref","unstructured":"Bergstr\u00f6m BS. Reply to: Pascal's law has no role in intraurethral pressure transmission or urethral closure. Neurourol Urodyn. 2025;","DOI":"10.1002\/nau.70029"},{"key":"6391_CR14","doi-asserted-by":"crossref","unstructured":"Bergstr\u00f6m BS. Abdominal pressure transmission in continent and stress incontinent women. 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Urol Cutaneous Rev. 1913;17(6):335\u201340.","journal-title":"Urol Cutaneous Rev."}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-025-06391-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-025-06391-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-025-06391-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T12:52:36Z","timestamp":1784551956000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-025-06391-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,29]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["6391"],"URL":"https:\/\/doi.org\/10.1007\/s00192-025-06391-9","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,29]]},"assertion":[{"value":"13 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None.","order":1,"name":"Ethics","label":"Conflicts of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This\u00a0article presents a novel explanatory framework whose clinical applicability has not yet been validated. The interpretations and surgical implications discussed are based on\u00a0anatomical analysis, physical principles, clinical experience, and mental simulations, and should therefore be regarded as theoretical until confirmed\u00a0through rigorous clinical research.","order":2,"name":"Ethics","label":"Disclaimer","group":{"name":"EthicsHeading","label":"Declarations"}}]}}