Cesarean section: Does it really prevent the development of postpartum stress urinary incontinence? a prospective study of 363 women one year after their first delivery

Groutz, Asnat; Rimon, Ephraim; Peled, Simona; Gold, Ronen; Pauzner, David; Lessing, Joseph B.; Gordon, David

doi:10.1002/nau.10166

Cited by 117 publications

(91 citation statements)

References 15 publications

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“…Incontinence rates have not been correlated with delivery method, but elective cesarean sections without attempting labor have been associated with a significantly lower prevalence of postpartum urinary incontinence. 2 It is questionable whether cesarean section delivery can prevent pelvic floor injury, [3][4][5] but recent data have suggested that this protective effect is less pronounced and that gestational urinary incontinence appears to be the most important predictive factor for developing postnatal urinary incontinence. [6][7][8] The risk of urinary incontinence has been found to be higher among women who had only experienced cesarean delivery than among nulliparous women, and even higher among those who had only delivered vaginally.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

et al. 2013

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CONTEXT AND OBJECTIVE: There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them. DESIGN AND SETTING: Cross-sectional study, conducted in a public university. METHODS: 220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer. RESULTS:The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m 2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence. CONCLUSION: Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence. RESUMOCONTEXTO E OBJETIVO: É ainda controversa na literatura a teoria de que eventos obstétricos e traumas no assoalho pélvico representariam menor risco para mulheres submetidas ao parto cesárea do que para aquelas submetidas a parto vaginal, no tocante a subsequente incontinência urinária. O objetivo do estudo foi avaliar a prevalência de incontinência urinária e disfunção muscular do assoalho pélvico dois anos após o parto e os fatores responsáveis por elas. TIPO DE ESTUDO E LOCAL: Estudo transversal conduzido em universidade pública. MÉTODOS: Foram selecionadas 220 mulheres dois anos após parto cesáreo eletivo ou parto vaginal. Foram avaliados sintomas de incontinência urinária e disfunção muscular do assoalho pélvico por palpação digital e perineômetro. RESULTADOS: A prevalência de incontinência urinária dois anos após parto vaginal e cesárea foi de 17% e 18,9% respectivamente. O único fator de risco para disfunção muscular do assoalho pélvico foi o ganho de peso durante a gestação. Índice de massa corporal inferior a 25 kg/m 2 e disfunção muscular do assoalho pélvico normal foram fatores de proteção contra incontinência urinária. Incontinência urinária na gestação aumentou o risco de incontinência urinária dois anos pós-parto. CONCLUSÃO: Incontinência urinária gestacional foi um precursor crucial de incontinência urinária pós-parto. O ganho de peso durante a gestação aumentou o risco posterior de disfunção muscular do assoalho pélvico e o parto cesárea eletivo não foi uma ação de prevenção para a incontinência urinária.

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Section: Introductionmentioning

confidence: 99%

Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

et al. 2013

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“…Recent studies show that women undergoing elective cesarean section had a lower prevalence of SUI than those undergoing this procedure on an emergency basis because of obstructed labor and they had the same prevalence of urinary disorder as the women who gave birth via vaginal delivery. 43,44 Considering the findings of these studies, we believe that, in regions where the percentage of elective cesarean delivery is very high due to cultural or socioeconomic issues, there may be a low prevalence of SUI even in multiparas.…”

Section: Discussionmentioning

confidence: 94%

Incontinência urinária de esforço em mulheres pertencentes ao Programa de Saúde da Família de Dourados (MS)

Gomes¹,

Silva²

2010

Rev. Assoc. Med. Bras.

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StreSS urinary incontinence among women participating in the family health program of DouraDoS (mS), Brazil 649Rev Assoc Med Bras 2010; 56(6): 649-54 IntroductIonUrinary incontinence (UI) is defined as involuntary loss of urine through the urethra. 1 This condition can be classified into three common types: stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence. In SUI, urine leakage occurs when there is increased intraabdominal pressure, such as while practicing physical exercise, coughing, or sneezing. UUI is the inability to hold urine because of a strong need to void. Mixed urinary incontinence is a combination of the two previous conditions. 2 The economic impact of UI is significant both for the public health system and the families of patients with this pathology. In the United States, the cost of the treatment of patients with UI was estimated to be approximately $ 19.5 million in 2000. 3 The annual amount paid for routine care of a U.S. woman with UI was estimated at $ 900.00. 4 Studies have shown the negative impact of UI on the social, sexual, and psychological dimensions. 5 Fultz et al. assessed the impact of UI in 3,364 employed women and demonstrated impairment of work rhythm because of increased frequency of bathroom breaks. 6 Tamanini et al., using the International Consultation on Incontinence Questionnaire (ICIQ-SF), showed that among 225 patients with UI, 8.9% (20) and 17.8% (40) considered the impact of this condition on their quality of life to be severe and very severe, respectively. 7 Telephone interviews conducted in 2003 with 82,196 people over 65 years demonstrated that the prevalence of UI is twice as high in women compared to men and UI is significantly associated with depression. 8 The prevalence of female UI can range from 8.5% to 55%. showed a weak association. Using logistic regression, only pairing of weight and hysterectomy was able to predict the outcome (SUI). Most women with SUI (63.9%) had very severe impairment in the QOL. conclusIon. The prevalence of SUI was similar to that found in other studies; BMI, parity, number of pregnancies, and hysterectomy were associated with this disease, which seriously impairs the QOL.

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“…Nevertheless, there are many factors that need to be accounted for such as age, body mass index, number of births, and presence of UI prepartum [5,24]. The older the mother the greater potential of having UI postpartum as well as the presence of UI before the gestational period.…”

Section: Discussionmentioning

confidence: 99%

“…Previously this procedure was implemented to reduce adverse risks for the fetus, with the added risk of complications for the mother minimally considered [3]. However rising cesarean rates can be attributed to the maternal concern and prevention of pelvic floor damage as well as urinary incontinence (UI), which have been highlighted in medical practice and touted as common symptoms of post-vaginal delivery [1,[4][5][6][7]. However, some of the literature reports natural vaginal delivery (NVD) as the best alternative to heal the female body [8].…”

Section: Introductionmentioning

confidence: 99%

Pelvic pain, pelvic organ prolapse, urinary and colorectal distress incidence and relationship to quality of life and birth mode

Walton¹,

Abreu²,

Jeffus³

et al. 2015

Phys Ther Rehabil

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Purpose: To determine the incidence and impact of pelvic pain, pelvic organ prolapse, urinary and colorectal distress and quality of life by birth mode for women in the chronic postpartum period. Study design: Cross-sectional correlational design utilizing purposive sampling of (n=21) female postpartum subjects ages 18-45. Background: Caesarean Section (CS) incidence is reported at 32% nationwide, well above the recommended safe rate of 10% (WHO). Literature is not clear regarding role of birth mode in postpartum symptoms including: pelvic pain, colorectal distress, pelvic organ prolapse, and quality of life. Methods: Data collection took place after IRB approval from Andrews University. Each subject who agreed to volunteer for the study and met the inclusion criteria completed (1) Health History Questionnaire, (2) SF-36, and (3) Pelvic Floor Distress Inventory. Result: Incidence reports of UI were 80% in CS and 50% in the NVD group. The CS reported significantly higher mean scores for PFIQb, UDI, POPDI and CRADI. Age was negatively correlated with CRADI and pain (Chi-square=7.02, p=0.030). NVD reported a significantly higher quality of life (as measured by the SF-36) in general and mental health compared to published norms and CS (p<0.05). BMI showed a significant moderate correlation (r=0.682, p<0.001) with pelvic organ prolapse. Conclusion: Our study found significant increased incidence and impact of UI, CRADI, POPDI and PFIQb symptoms and a decrease in QOL in CS compared to NVD. Age showed significant correlation with colorectal symptoms and BMI showed significant relationship to pelvic organ prolapse.

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Cesarean section: Does it really prevent the development of postpartum stress urinary incontinence? a prospective study of 363 women one year after their first delivery

Cited by 117 publications

References 15 publications

Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

Incontinência urinária de esforço em mulheres pertencentes ao Programa de Saúde da Família de Dourados (MS)

Pelvic pain, pelvic organ prolapse, urinary and colorectal distress incidence and relationship to quality of life and birth mode

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