{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:42:25Z","timestamp":1792147345847,"version":"4.4.0"},"reference-count":17,"publisher":"BMJ","issue":"6661","license":[{"start":{"date-parts":[[1988,12,3]],"date-time":"1988-12-03T00:00:00Z","timestamp":597110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1988,12,3]]},"abstract":"<jats:p>A potential association between abnormal electromyographic activity--that is, decelerating bursts and complex repetitive discharges--of the urethral sphincter and difficulty in voiding was examined in 57 women with urinary retention. Abnormal electromyographic activity was found in 33. Ultrasonography of the ovaries in 22 of the 33 women showed that 14 had polycystic ovaries. Of the other eight women, two had had oophorectomies, one had shrunken ovaries and ovarian failure, and one had previously undergone oophorectomy and the other ovary could not be seen; in one neither ovary could be seen, and three had ovaries of normal appearance, although two of these women were taking the contraceptive pill. Thirteen of the group had endocrine symptoms and signs characteristic of the polycystic ovary syndrome. Videocystometrography in 17 of the women who were examined by ultrasonography showed low flow rates and high residual volumes of urine after micturition in 12 women who could void, the other five having chronic urinary retention. A speculative hypothesis for the observed association of impaired voiding, abnormal electromyographic activity of the urinary sphincter, and polycystic ovaries is advanced, based on the relative progesterone deficiency that characterises the polycystic ovary syndrome. Progesterone stabilises membranes, and its depletion might permit ephaptic transmission of impulses between muscle fibres in the muscle of the urethral sphincter, giving rise to the abnormal electromyographic activity. This may impair relaxation of the sphincter, resulting in low flow rates of urine, incomplete emptying of the bladder, and, finally, urinary retention.<\/jats:p>","DOI":"10.1136\/bmj.297.6661.1436","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"1436-1438","source":"Crossref","is-referenced-by-count":218,"title":["Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome?"],"prefix":"10.1136","volume":"297","author":[{"given":"C. J.","family":"Fowler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. J.","family":"Christmas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. R.","family":"Chapple","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. F.","family":"Parkhouse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. S.","family":"Kirby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. S.","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1988,12,3]]},"reference":[{"key":"ref_1","first-page":"69","article-title":"Abnormal electromyographic activity (decelerating burst and complex repetitive discharges) in the striated muscle of the urethral sphincter in 5 women with persisting urinary retentton","volume":"57","author":"Fowler, C.J.; Kirby, R.S.","year":"1985","unstructured":"Fowler CJ, Kirby RS. Abnormal electromyographic activity (decelerating burst and complex repetitive discharges) in the striated muscle of the urethral sphincter in 5 women with persisting urinary retentton. BrJ Urol 1985;57:69-70.","journal-title":"BrJ Urol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1136\/jnnp.48.10.1004","article-title":"Decelerating burst and complex repetitive discharges in the striated muscle of the urethral sphincter, associated with urinary retention in women","volume":"48","author":"Fowler, C.J.; Kirby, R.S.; Harrison, M.J.G.","year":"1985","unstructured":"Fowler CJ, Kirby RS, Harrison MJG. Decelerating burst and complex repetitive discharges in the striated muscle of the urethral sphincter, associated with urinary retention in women. J7 Neurol Neurosurg Psychiatry 1985;48: 1004-9.","journal-title":"J7 Neurol Neurosurg Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1016\/S0140-6736(86)91497-2","article-title":"Electromyography of urethral sphincter in women with urinary retention","volume":"i:","author":"Fowler, C.J.; Kirby, R.S.","year":"1986","unstructured":"Fowler CJ, Kirby RS. Electromyography of urethral sphincter in women with urinary retention. Lancet 1986;i: 1455-6.","journal-title":"Lancet"},{"key":"ref_4","first-page":"302","article-title":"Psychogenic urinary retention","volume":"65","author":"Allen, T.D.","year":"1972","unstructured":"Allen TD. Psychogenic urinary retention. South MedJ7 1972;65:302-4."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/S0140-6736(85)92552-8","article-title":"Multifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotrophin releasing hormone","volume":"ii:","author":"Adams, J.; Franks, S.; Polson, D.W.","year":"1985","unstructured":"Adams J, Franks S, Polson DW, et al. Multifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotrophin releasing hormone. Lancet 1985;ii:1375-8.","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S0306-3356(21)00138-2","article-title":"Ovulatory disorders in women with polycystic ovary syndrome","volume":"12","author":"Franks, S.; Adams, J.; Mason, H.; Polson, D.","year":"1985","unstructured":"Franks S, Adams J, Mason H, Polson D. Ovulatory disorders in women with polycystic ovary syndrome. Clinics in Obstetrics and Gynaecology 1985;12: 605-32.","journal-title":"Clinics in Obstetrics and Gynaecology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3109\/09513598709082702","article-title":"Polycystic ovaries and polycystic ovary syndrome","volume":"1","author":"Jacobs, H.S.","year":"1987","unstructured":"Jacobs HS. Polycystic ovaries and polycystic ovary syndrome. Gynaecological Endocrinology 1987;1:113-31.","journal-title":"Gynaecological Endocrinology"},{"key":"ref_8","first-page":"355","article-title":"Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism","volume":"293","author":"Adams, J.; Polson, D.W.; Franks, S.","year":"1986","unstructured":"Adams J, Polson DW, Franks S. Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. BrMedJf 1986;293:355-9.","journal-title":"BrMedJf"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/j.1464-410X.1955.tb03459.x","article-title":"Investigation of disturbances in the striated muscle of the urethral sphincter","volume":"27","author":"Frankssen, C.; Petersen, I.","year":"1955","unstructured":"Frankssen C, Petersen I. Investigation of disturbances in the striated muscle of the urethral sphincter. BrJ Urol 1955;27:154-61.","journal-title":"BrJ Urol"},{"key":"ref_10","first-page":"\"773","article-title":"A new approach to electromyography of the external urethral sphincter","volume":"117","author":"Blaivas, J.G.; Labib, K.L.; Bauer, S.B.; Retik, A.B.","year":"1977","unstructured":"Blaivas JG, Labib KL, Bauer SB, Retik AB. A new approach to electromyography of the external urethral sphincter. 7 Urol 1977;117:773-7. 1 1 Fowler CJ, Kirby RS, Harrison MJ, Milroy FJ, Turner-Warwick R. Individual motor unit analysis in the diagnosis of disorders of urethral sphincter innervation. J7 Neurol Neurosurg Psychiany 1984;47:637-41.","journal-title":"J7 Neurol Neurosurg Psychiany; Individual motor unit analysis in the diagnosis of disorders of urethral sphincter innervation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/S0300-595X(86)80031-7","article-title":"Treatment of hirsutism and acne with cyproterone acetate","volume":"15","author":"Miller, J.A.; Jacobs, H.S.","year":"1986","unstructured":"Miller JA, Jacobs HS. Treatment of hirsutism and acne with cyproterone acetate. Clinics in Endocrinology and Metabolism 1986;15:373-89.","journal-title":"Clinics in Endocrinology and Metabolism"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/S0022-5347(17)56629-X","article-title":"Pseudomyotonia of the periurethral sphincter in women with urinary incontinence. J'","volume":"122","author":"Butler, W.J.","year":"1979","unstructured":"Butler WJ. Pseudomyotonia of the periurethral sphincter in women with urinary incontinence. J' Urol 1979;122:838-40.","journal-title":"Urol"},{"key":"ref_13","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.; Juvarra, G.; Bettoni, L.; Stagha, G.","year":"1983","unstructured":"Potenzoni D, Juvarra G, Bettoni L, Stagha G. Pseudomyotonia of the striated urethral sphincter. J Urol 1983;130:512-3.","journal-title":"J Urol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/nau.1930020105","article-title":"Complex repetitive discharges in the external urethral sphincter in the pediatric population","volume":"2","author":"Dyro, F.M.; Bauer, S.B.; Hallett, M.","year":"1983","unstructured":"Dyro FM, Bauer SB, Hallett M, et al. Complex repetitive discharges in the external urethral sphincter in the pediatric population. Neurology and Urodynamics 1983;2:39-44.","journal-title":"Neurology and Urodynamics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/S0140-6736(88)91612-1","article-title":"Polycystic ovaries-a common finding in normal women","volume":"i:","author":"Polson, D.W.; Adams, J.; Wadsworth, J.","year":"1988","unstructured":"Polson DW, Adams J, Wadsworth J, et al. Polycystic ovaries-a common finding in normal women. Lancet 1988;i:870-2.","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/0022-510X(79)90156-4","article-title":"Pathogenesis of ano-rectal incontinence: a histometric study of the anal sphincter musculature","volume":"42","author":"Beersiek, F.; Parks, A.G.; Swash, M.","year":"1979","unstructured":"Beersiek F, Parks AG, Swash M. Pathogenesis of ano-rectal incontinence: a histometric study of the anal sphincter musculature. J3 Neurol Sci 1979;42: 111-27.","journal-title":"J3 Neurol Sci"},{"key":"ref_17","first-page":"47","article-title":"Vasoactive intestinal polypeptide (VIP)-immunoreactive nerve fibres associated with the striated muscle of the human external urethral sphincter","volume":"i:","author":"Crowe, R.; Light, J.K.; Chilton, C.P.; Burnstock, G.","year":"1985","unstructured":"Crowe R, Light JK, Chilton CP, Burnstock G. Vasoactive intestinal polypeptide (VIP)-immunoreactive nerve fibres associated with the striated muscle of the human external urethral sphincter. Lancet 1985;i:47-8.","journal-title":"Lancet"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.297.6661.1436","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.297.6661.1436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T18:54:36Z","timestamp":1765479276000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.297.6661.1436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1988,12,3]]},"references-count":17,"journal-issue":{"issue":"6661","published-online":{"date-parts":[[1988,12,3]]},"published-print":{"date-parts":[[1988,12,3]]}},"alternative-id":["10.1136\/bmj.297.6661.1436"],"URL":"https:\/\/doi.org\/10.1136\/bmj.297.6661.1436","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1988,12,3]]}}}