Study objective-The aim was to investigate the possible association between parity, as indicated by the number of childbirths, and prevalence of urinary incontinence in an adult female population sample.Design and setting-A sample of 3114 women aged 30-59 years was selected at random from the population of Aarhus, Denmark, and mailed a self administered questionnaire on urinary incontinence and, among other things, parity.Participants-A total of 2631 questionnaires was returned (85%) with a slight but significant decrease in respondency by age.Main results-The 1987 urinary incontinence period prevalence was 17%. Seventy eight percent were parous, and 24% had had three or more childbirths. In women aged 30-44 years, the prevalence of urinary incontinence was found to be associated with parity and, in women aged 45 years and more, with three or more childbirths. In parous women 30-44 years ofage, the prevalence of urinary incontinence increased with age at last childbirth and, in women aged 45 years and over, it increased with increasing parity but decreased with increasing age at first childbirth. In parous women, no association was found with time since last childbirth. Among clinical types of urinary incontinence, stress incontinence consistently showed the strongest associations with indicators of parity. In women aged 30-44 years, nearly two thirds of the 1987 prevalence of stress incontinence could be attributed to parity.Conclusions-These findings support the hypothesis that pregnancy and childbirth are potent causes of female urinary incontinence, so that they exert considerable impact on the level of population urinary incontinence prevalence. In the individual woman, the effect seems to be cumulative and long lasting but fades with age. 7 Epidemiol Community Health 1992; 46: 595-600The experience of episodes of urinary incontinence, involuntary loss of urine, seems to be a condition prevalent not only in elderly women but also in the young and middle aged female populations of western industrialised countries. In publications on the prevalence of urinary incontinence (PuI) In spite of the fact that much is known about the pathophysiology and the clinical features of urinary incontinence, documentation on its aetiology is scarce. Several factors may determine adult female Pu1, eg, age2 and health status.3 Moreover, in everyday medical practice pregnancy and childbirth are thought to be potent causes of urinary incontinence, but published studies investigating possible associations between pregnancy or childbirth and incontinence are rare and their findings seem mutually conflicting.We have been able to identify only a few studies concerned with the prevalence of urinary incontinence, while none deals with incidence. Table I gives an overview of such published cross sectional studies on parity-indicating pregnancies and childbirths in the past-and Pu, that present information sufficient for reanalysis for comparison of findings. The reanalyses had to be restricted to bivariate associations, as none...

Intra-operative systematic local infiltration analgesia reduces postoperative pain in patients undergoing vaginal hysterectomy, facilities mobilization and improves early recovery.

In a cross-sectional study, 85% of 3114 women responded to a questionnaire on urinary incontinence and a history of abdominal, gynaecological and urological surgery. In 1987 the prevalence of urinary incontinence was 17%; 63% had undergone surgery, mainly gynaecological, and almost one-third of the respondents had had more than one operation. Bivariate and multivariate analysis showed stress urinary incontinence to be associated with previous exposure to surgery.