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Edward J. McGuire, MD
University of Michigan Ann Arbor

JAMA. 1984;251(7):890-891.

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In Reply.—

The article in question was the result of a telephone interview, and I had no opportunity to review it before its publication. I have no strong disagreement with the statements of Drs McNeal and Bostwick contained in their letter. I have never claimed to have discovered a "new third zone" of the sphincter, nor did I specifically identify the "crucial" zone as entirely smooth muscle in composition. The diagram printed with the article is inaccurate and improperly labeled.

My statements to the American Urologic Association were the result of 12 years of combined roentgenographic and manometric studies of urethral sphincter function involving some 6,500 patients. In essence, the voluntary sphincter, which is clearly composed of skeletal musculature, compresses an area of the urethra that is identifiable radiographically and by pressure recordings and is commonly known as the external sphincter. Proximal to that area, extending superiorly to the distal . . . [Full Text PDF of this Article]

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