Changes in vesical neck mobility following vaginal delivery

Peschers, Ursula; Schaer, Gabriel N.; Anthuber, C.; DeLancey, John O.L.; Schuessler, Bernhard

doi:10.1016/s0029-7844(96)00338-9

Cited by 183 publications

(93 citation statements)

References 14 publications

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“…(7)(8)(9) Studies of the continence mechanism after birth have focused on vesical neck movement alone (10,11) or were conducted early in the postpartum period before full recovery had occurred. (12) The present study seeks to compare the relative contributions of urethral function and urethral mobility to stress incontinence at a point in time when the pelvic floor has fully recovered.…”

Section: Introductionmentioning

confidence: 99%

Vaginal Birth and De Novo Stress Incontinence

DeLancey

Miller

Kearney

et al. 2007

Obstetrics &Amp; Gynecology

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Section: Introductionmentioning

confidence: 99%

Vaginal Birth and De Novo Stress Incontinence

DeLancey

Miller

Kearney

et al. 2007

Obstetrics &Amp; Gynecology

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“…Subjective assessment of urine leakage is often difficult, and where pad tests have been used to objectively measure urine loss, there was poor sensitivity in screening for USI 4 . Vaginal delivery has been implicated as a major risk factor for postpartum incontinence as it is thought that trauma to the pelvic floor either from nerve damage or weakening of the supportive structures leads to USI 1,5,6 . In this study, even in women who underwent caesarean section, 9% were found to have either USI or detrusor instability, all of whom did not undergo the second stage of labour when it could be postulated that the majority of damage to the pelvic floor occurs as the fetal head rests and is pushed against the pelvic floor.…”

Section: Discussionmentioning

confidence: 99%

Urinary symptoms in pregnancy: are they useful for diagnosis?

Chaliha¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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This is the second part of a study assessing 161 women 12 weeks after their first delivery. The urodynamic data have previously been published [Br J Obstet Gynaecol 2000;107:1354]. The symptoms have been assessed using a (non-validated) urinary symptom questionnaire. There was no correlation between symptoms and urodynamic findings and most importantly between the symptom of stress incontinence, a diagnosis of urodynamic stress incontinence (USI) and vaginal delivery. Symptoms of incontinence and abnormal urodynamic findings were also found in women who underwent caesarean section. These data explain why caesarean section does not appear to be wholly protective in preventing postpartum incontinence. This suggests that the aetiology of postpartum incontinence is multifactorial and urinary symptoms are misleading in determining the underlying causes.

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“…Limited denervation of the pelvic fl oor is supposed to be pudendal nerve injury resulting from vaginal delivery injuries or prolonged abdominal pulling during fetal expulsion 24 . Soft tissue damage during childbirth might weaken post-delivery bladder neck support and as a consequence can produce some sort of weakness of paraurethral connective tissue and fascial structures, altogether resulting in stress urinary incontinence [25][26][27] . Fibrosis and damages to the levator ani muscle during vaginal childbirth may also contribute to this condition 28 .…”

Section: Impact Of Pregnancy and Delivery On Urinary Incontinencementioning

confidence: 99%

Effect of Delivery and Episiotomy on the Emergence of Urinary Incontinence in Women: Review of Literature

Živković

Župić

et al. 2016

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SUMMARY -Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the fi rst half of the 20 th century and was performed mediolaterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic fl oor from injuries. However, reports claiming that episiotomy had no such benefi ts were published. It was shown that routine mediolateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased. Th e role of episiotomy in development of pelvic fl oor dysfunction remains quite unclear. Due to the mentioned reason, restricted episiotomy approach should be accepted. Th e origin of stress incontinence during pregnancy is controversial and not definitely scientifi cally proven. Pregnancy per se and older age at fi rst delivery may have impact on the onset of pelvic fl oor dysfunction. Urinary incontinence in pregnancy increases the risk of later urinary incontinence, both postpartum and later in life. Vaginal delivery is just one of the potential risk factors for development of urinary incontinence. Mechanical pressure by fetus on the pelvic fl oor structures, limited denervation of the pelvic fl oor and soft tissue damage during delivery are some of explanations for the onset of stress urinary incontinence. On the other hand, cesarean delivery might not be protective against emergence of urinary incontinence. Further research in this fi eld is needed.

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Changes in vesical neck mobility following vaginal delivery

Abstract: Vaginal delivery alters vesical neck descent during the Valsalva maneuver, and the ability of the pelvic muscles to elevate the urethra in some women.

Cited by 183 publications

References 14 publications

Vaginal Birth and De Novo Stress Incontinence

Vaginal Birth and De Novo Stress Incontinence

Urinary symptoms in pregnancy: are they useful for diagnosis?

Effect of Delivery and Episiotomy on the Emergence of Urinary Incontinence in Women: Review of Literature

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