Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
Letter to the Editor: In the Scientific Review
of urinary incontinence, Drs Holroyd-Leduc and Straus1 did
not discuss the structure of the connective tissue as a risk factor. For instance,
women with decreased collagen content and altered morphology in the pelvic
support tissue may be at higher risk of stress incontinence.2,3 We4 reported significant reduction of collagen content
in the uterine cervix among women with stress urinary incontinence, regardless
of age, parity, body mass index, or tobacco use. This suggests that a systemic
defect in collagen production, rather than damage to local collagen in the
pelvic floor, may predispose to urinary incontinence.
Harmanli OH, Dandolu V, Chatwani AJ. Cartilage Structure as a Risk Factor for Urinary Incontinence. JAMA. 2004;291(20):2431-2432. doi:10.1001/jama.291.20.2431-b