{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T14:55:51Z","timestamp":1770735351525,"version":"3.49.0"},"reference-count":55,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,5,4]],"date-time":"2015-05-04T00:00:00Z","timestamp":1430697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"East Manchester Research and Ethics Committee"},{"name":"Research and Development Team at Salford Royal NHS Foundation Trust"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2015,9]]},"abstract":"\n Objective<\/jats:title>\n \n To investigate by electromyography (\n EMG<\/jats:styled-content>\n ), the presence of complex repetitive discharges (\n CRD<\/jats:styled-content>\n s) and decelerating bursts (\n DB<\/jats:styled-content>\n s) in the striated external urethral sphincter during the menstrual cycle in female volunteers with no urinary symptoms and complete bladder emptying.\n <\/jats:p>\n <\/jats:sec>\n \n Subjects and Methods<\/jats:title>\n \n Healthy female volunteers aged 20\u201340\u00a0years, with regular menstrual cycles and no urinary symptoms were recruited. Volunteers completed a menstruation chart, urinary symptom questionnaires, pregnancy test, urine dipstick, urinary free flow and post\u2010void ultrasound bladder scan. Exclusion criteria included current pregnancy, use of hormonal medication or contraception, body mass index of >35\u00a0kg\/m\n 2<\/jats:sup>\n , incomplete voiding and a history of pelvic surgery. Eligible participants underwent an external urethral sphincter\n EMG<\/jats:styled-content>\n , using a needle electrode in the early follicular phase and the mid\u2010luteal phase of their menstrual cycles. Serum oestradiol and progesterone were measured at each\n EMG<\/jats:styled-content>\n test.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In all, 119 women enquired about the research and following screening, 18 were eligible to enter the study phase. Complete results were obtained in 15 women. In all, 30\n EMG<\/jats:styled-content>\n tests were undertaken in the 15 asymptomatic women. Sphincter\n EMG<\/jats:styled-content>\n was positive for\n CRD<\/jats:styled-content>\n s and\n DB<\/jats:styled-content>\n s at one or both phases of the menstrual cycle in eight (53%) of the women. Three had\n CRD<\/jats:styled-content>\n s and\n DB<\/jats:styled-content>\n s in both early follicular and mid\u2010luteal phases. Five had normal\n EMG<\/jats:styled-content>\n activity in the early follicular phase and\n CRD<\/jats:styled-content>\n s and\n DB<\/jats:styled-content>\n s in the mid\u2010luteal phase. No woman had abnormal\n EMG<\/jats:styled-content>\n activity in the early follicular phase and normal activity in the luteal phase. There was no relationship between\n EMG<\/jats:styled-content>\n activity and age, parity or serum levels of oestradiol and progesterone.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CRD<\/jats:styled-content>\n s and\n DB<\/jats:styled-content>\n activity in the external striated urethral sphincter is present in a high proportion of asymptomatic young women. This abnormal\n EMG<\/jats:styled-content>\n activity has been shown for the first time to change during the menstrual cycle in individual women.\n CRD<\/jats:styled-content>\n s and\n DB<\/jats:styled-content>\n s are more commonly found in the luteal phase of the menstrual cycle. The importance of\n CRD<\/jats:styled-content>\n s and\n DB<\/jats:styled-content>\n s in the aetiology of urinary retention in young women remains uncertain. The distribution and or quantity of abnormal\n EMG<\/jats:styled-content>\n activity in the external urethral sphincter may be important. In a woman with urinary retention the finding of\n CRD<\/jats:styled-content>\n s and\n DB<\/jats:styled-content>\n s by needle\n EMG<\/jats:styled-content>\n does not automatically establish Fowler's syndrome as the explanation for the bladder dysfunction. Urethral pressure profilometry may be helpful in establishing a diagnosis. Opiate use and psychological stress should be considered in young women with urinary retention.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.13042","type":"journal-article","created":{"date-parts":[[2015,1,20]],"date-time":"2015-01-20T02:34:53Z","timestamp":1421721293000},"page":"423-431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["External urethral sphincter electromyography in asymptomatic women and the influence of the menstrual cycle"],"prefix":"10.1111","volume":"116","author":[{"given":"Cecile","family":"Tawadros","sequence":"first","affiliation":[{"name":"Department of Urology Salford Royal NHS Foundation Trust Salford UK"},{"name":"Department of Urology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Burnett","sequence":"additional","affiliation":[{"name":"Department of Urology Salford Royal NHS Foundation Trust Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura F.","family":"Derbyshire","sequence":"additional","affiliation":[{"name":"Department of Urology Salford Royal NHS Foundation Trust Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Tawadros","sequence":"additional","affiliation":[{"name":"Department of Urology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noel W.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Urology Salford Royal NHS Foundation Trust Salford UK"},{"name":"Department of Urology Christie Hospitals NHS Foundation Trust Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Betts","sequence":"additional","affiliation":[{"name":"Department of Urology Salford Royal NHS Foundation Trust Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.48.10.1004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1985.tb08988.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6661.1436"},{"key":"e_1_2_7_5_1","first-page":"367","volume-title":"Neurology of Bladder, Bowel, and Sexual Dysfunction","author":"Swinn MJ","year":"1999"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)56629-X"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.46.4.310"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655902320765971"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2011.00063"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050451"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000156833.84907.3d"},{"key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/S0022-5347(17)51278-1","article-title":"Pseudomyotonia of the striated urethral sphincter","volume":"130","author":"Potenzoni D","year":"1983","journal-title":"J Urol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.1930020105"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.1930020403"},{"key":"e_1_2_7_15_1","first-page":"69","article-title":"The importance of complex repetitive discharges in the striated female urethral sphincter and the male bulbocavernosus muscle","volume":"179","author":"Jensen D","year":"1996","journal-title":"Scand J Urol Nephrol Suppl"},{"key":"e_1_2_7_16_1","first-page":"273","article-title":"Complex repetitive discharges during urethral sphincter electromyography: clinical correlates","volume":"18","author":"Fitzgerald M","year":"1999","journal-title":"Neurourol Urodyn"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1992.tb15657.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1994.tb07606.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511762611.021"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)35246-1"},{"issue":"1","key":"e_1_2_7_21_1","first-page":"82","article-title":"Are whaling women normal?","volume":"88","author":"Kujawa ML","year":"2001","journal-title":"BJU Int"},{"key":"e_1_2_7_22_1","unstructured":"BromageS KujawaMS MooreK TawadrosC BettsCD.Are whaling women normal? 10 year follow up of \u2018Whale Positive\u2019 asymptomatic women. 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