Fecal and Urinary Incontinence in Primiparous Women

Borello‐France, Diane; Burgio, Kathryn L.; Richter, Holly E.; Zyczynski, Halina M.; FitzGerald, Mary P.; Whitehead, William E.; Fine, Paul; Nygaard, Ingrid; Handa, Victoria L.; Visco, Anthony G.; Weber, Anne M.; Brown, Morton B.

doi:10.1097/01.aog.0000232504.32589.3b

Cited by 255 publications

(203 citation statements)

References 33 publications

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“…As already mentioned, vaginal delivery carries a higher risk of urinary incontinence but anal sphincter injuries do not aff ect the occurrence of urinary incontinence. Some authors report a similar incidence of urinary incontinence after vaginal delivery and cesarean section 71 . Intrapartum cesarean section lost protective eff ect on the occurrence of urinary incontinence and only per-delivery elective cesarean section retains protective eff ect 71 .…”

Section: Impact Of Episiotomy On Urinary Incontinence After Deliverymentioning

confidence: 84%

“…Some authors report a similar incidence of urinary incontinence after vaginal delivery and cesarean section 71 . Intrapartum cesarean section lost protective eff ect on the occurrence of urinary incontinence and only per-delivery elective cesarean section retains protective eff ect 71 . According to Casey et al, episiotomy increases the risk of urinary incontinence alone as an independent factor, and in association with other factors (macrosomia, epidural analgesia, and oxytocin augmentation of delivery) 69 .…”

Section: Impact Of Episiotomy On Urinary Incontinence After Deliverymentioning

confidence: 84%

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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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Section: Impact Of Episiotomy On Urinary Incontinence After Deliverymentioning

confidence: 84%

Section: Impact Of Episiotomy On Urinary Incontinence After Deliverymentioning

confidence: 84%

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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“…Lo anterior puede estar dado ya sea por una disrupción del EAE o EAI, que ocurre principalmente por el daño obstétrico [17][18][19][20] en pacientes jóvenes y sanas en su mayoría asintomáticas hasta la menopausia, así como también por un adelgazamiento esfinteriano observado en pacientes añosos 21 . Kim YS et al 22 , demostró que esta alteración anatómica de ambos esfínteres, se correlaciona con alteraciones de la contracción en la manometría.…”

Section: Discussionunclassified

Relación Entre El Grado De Incontinencia Fecal Y El Daño Del Esfínter Anal Externo

et al. 2015

Rev Chil Cir

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relationship between faecal incontinence severity and external anal sphincter disruption introduction: Faecal incontinence (FI) represents an important psychological and social condition for an individual. There are several causes for FI, therefore its study and management is complex. Among different aetiologies, anatomical disruption of the external anal sphincter (EAS) as a consequence of anorrectal surgery or obstetric injury can be studied by endoanal ultrasound (EAUS). This study focus on anatomical assessment of sphincter muscle injury of EAS and its relationship with clinical presentation con FI. Objective: Compare anatomical and disruption of EAS features studied by 3D-EAUS between patients with FI, according to its severity. methods: 3D-EAUS images were obtained from selected patients studied for FI between January 2008 and July 2010 at Clínica las Condes. Wexner Score (SW) was used to evaluate severity of FI, dividing patients into two categories: Mild FI (SW < 9) and Severe FI (SW ≥ 9). A single observer evaluated different morphological variables: width, length, percentage and angle of EAS disruption. Parametrical and non-parametrical analysis was used as appropriate. P-value < 0.05 was considered statistically significant. results: From 31 female patients studied, mean SW was 11.7 ± 0.8 points, range from 5 to 20 points. When dividing into two groups, 9 patients had mild FI and 22 had severe FI. Studied variables in EAUS 3D cubes: width, length, percentage and angle of EAS disruption, did not reach statistical significance between groups. conclusion: no relationship was found between external anal sphincter anatomic injury variables studied and severity of faecal incontinence.

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“…stup-ně nemají vliv na výskyt močové inkontinence (26,27,28). Borello-France et al (27) ve své prospektivní kohortové studii srovnávali výskyt močové inkontinence u žen s poraněním análního svěrače a u žen po vaginálním porodu bez tohoto poranění. Mezi skupinami nebyl zjištěn rozdíl ve výskytu močové inkontinence šest týdnů po porodu, ani šest měsíců po porodu.…”

Section: Legenda: Ns (Not Significant) -Nesignifikantní Hodnotaunclassified

“…Také velikost souborů a počet jednotlivých poranění může vést ke zkreslení vý-sledků. Například podle studie autorů Fritel et al (27), ruptura hráze III. stupně nepředstavuje rizikový faktor pro výskyt močové inkontinence, ale ze souboru 370 žen, rupturu hráze III.…”

Section: Výstupyunclassified

Perineal trauma and its effect on the pelvic floor and urinary incontinence

Kramná¹,

Vrublová²

2016

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1Ústav ošetřovatelství a porodní asistence, Lékařská fakulta, Ostravská univerzita, Ostrava, Česká republika 2 Gynekologicko-porodnická klinika, Lékařská fakulta, Ostravská univerzita, Ostrava, Česká republika ABSTRAKT Východiska: Vysoká prevalence močové inkontinence u žen představuje celosvětový problém. Častější výskyt problémů s únikem moči byl zaznamenán u žen po porodu. Některé studie zjistily souvislost mezi močovou inkontinencí a porodním poraněním. Cíl: Zjistit vliv porodního poranění hráze (epiziotomie, spontánní ruptury) na pánevní dno a močovou inkontinenci. Metody: K vyhledávání literárních zdrojů byly využity elektronické databáze Medline, Cinahl, Pub Med, Science Direct, Scopus, Medvik a elektronické vyhledávače Google a Google Scholar. Byly vyhledávány články v českém nebo anglickém jazyce. Při vyhledávání byla zadána klíčová slova: perineal trauma, episiotomy, childbirth, urinary incontinence. Celkem bylo dohledáno 21 studií: 1 metaanalýza, 3 systematická review, 2 randomizované kontrolované studie a 15 kohortových studií. Výsledky: Ženy s intaktní hrází měly silnější pánevní dno než ženy s porodním poraněním, přestože se významně nelišily ve výskytu močové inkontinence. Nebyla prokázána souvislost mezi močovou inkontinencí a rozsahem spontánního poranění. Epiziotomie nechrání pánevní dno a neredukuje výskyt močové inkontinence u žen po porodu. Závěr: Snahou porodníků a porodních asistentek by měla být maximální redukce porodních poranění hráze. V žádné studii nebyl ale prokázán pozitivní vliv epiziotomie na pánevní dno a snížení výskytu močové inkontinence, proto by v praxi měly být epiziotomie prováděny jen v indikovaných případech. ABSTRACTBackground: High prevalence of urinary incontinence in women is a worldwide problem. Higher incidence of problems with urinary incontinence was observed in women after childbirth. Some studies have found a connection between urinary incontinence and perineal trauma. Aim: To determine the influence of perineal trauma (episiotomy, spontaneous rupture) on the pelvic floor and urinary incontinence. Methods: In search for sources we used the electronic databases Medline, CINAHL, PubMed, Science Direct, Scopus, Medvik, and the electronic search engines Google and Google Scholar. We searched for articles in Czech or English. The following keywords were used: perineal trauma, episiotomy, childbirth, urinary incontinence. A total of 21 studies were found: 1 meta-analysis, 3 systematic reviews, 2 randomized controlled trials, and 15 cohort studies. Results: Women with an intact perineum had a stronger pelvic floor than women with a perineal injury, although they did not differ significantly in the incidence of urinary incontinence. A relationship between urinary incontinence and the extent of a spontaneous injury has not been proved. Episiotomy does not protect the pelvic floor and does not reduce the incidence of urinary incontinence in women after childbirth. Conclusion: Obstetricians and midwives should maximally reduce perineal injuries. No study has yet proven a...

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Fecal and Urinary Incontinence in Primiparous Women

Abstract: II-3.

Cited by 255 publications

References 33 publications

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

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

Relación Entre El Grado De Incontinencia Fecal Y El Daño Del Esfínter Anal Externo

Perineal trauma and its effect on the pelvic floor and urinary incontinence

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