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Female Continence

Inner urethra composed of longitudinal muscle layer
Outer urethra composed of semi-circular fibres forming sphincter mechanism (continuation of detrusor muscle)
- under parasympathetic (cholinergic) control
Inherent tone of urethra due to elastic tissue, collagen fibres, fascial attachments, voluntary muscle greatest in mid-third
voluntary muscle (puborectalis) is part of levator ani
- contraction stops micturition completely, acts as external sphincter
- contracts in response to coughing, bearing down, sneezing, heavy lifting
- under control of pudendal nerve
Transmission of increased abdominal pressure to proximal urethra helps to prevent stress incontinence

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