Parturition and Urinary Incontinence in Primiparas

Farrell, Scott A.; Allen, Victoria M.; Baskett, Thomas F.

doi:10.1097/00006250-200103000-00005

Cited by 55 publications

(90 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Maternal age and total births, however, showed the same associations for faecal as for urinary incontinence. 15 It has generally been assumed that caesarean section delivery protects against urinary incontinence and several studies, based on postpartum 1,5,11,12,20 and general populations, [2][3][4] have found this association. Pathophysiological studies have also demonstrated less damage, although neurological function may be affected by caesarean section during labour.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is little information on the prevalence of persistent postpartum urinary incontinence and the relationship between this and delivery history. Longitudinal studies of incontinence in postpartum populations have had only short follow up 11,12 or were not large enough to examine the effects of delivery mode history. 13,14 We have recently shown that while forceps delivery was predictive of persistent symptoms of faecal incontinence, neither a first birth caesarean section nor delivering exclusively by caesarean section was associated with a reduction in these symptoms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Persistent urinary incontinence and delivery mode history: a six‐year longitudinal study

MacArthur

Glazener²,

Wilson

et al. 2005

BJOG

119

115

View full text Add to dashboard Cite

Objective To investigate the prevalence of persistent and long term postpartum urinary incontinence and associations with mode of first and subsequent delivery.Design Longitudinal study.Setting Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand).Population Women (4214) who returned postal questionnaires three months and six years after the index birth.Methods Symptom data were obtained from both questionnaires and obstetric data from case-notes for the index birth and the second questionnaire for subsequent births. Logistic regression investigated the independent effects of mode of first delivery and delivery mode history.Main outcome measures Urinary incontinence-persistent (at three months and six years after index birth) and long term (at six years after index birth).Results The prevalence of persistent urinary incontinence was 24%. Delivering exclusively by caesarean section was associated with both less persistent (OR = 0.46, 95% CI 0.32-0.68) and long term urinary incontinence (OR = 0.50, 95% CI 0.40-0.63). Caesarean section birth in addition to vaginal delivery, however, was not associated with significantly less persistent incontinence (OR 0.93, 95% CI 0.67-1.29). There were no significant associations between persistent or long term urinary incontinence and forceps or vacuum extraction delivery. Other significantly associated factors were increasing number of births and older maternal age.Conclusions The risk of persistent and long term urinary incontinence is significantly lower following caesarean section deliveries but not if there is another vaginal birth. Even when delivering exclusively by caesarean section, the prevalence of persistent symptoms (14%) is still high.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Persistent urinary incontinence and delivery mode history: a six‐year longitudinal study

MacArthur

Glazener²,

Wilson

et al. 2005

BJOG

119

115

View full text Add to dashboard Cite

show abstract

“…There is a growing body of evidence in the medical literature implicating parturition with pelvic floor injury and its sequelae [1][2][3]. Controversy surrounds the interpretation of this literature and its implications [4,5].…”

Section: Introductionmentioning

confidence: 99%

The choice of elective cesarean delivery in obstetrics: a voluntary survey of Canadian health care professionals

2005

Self Cite

View full text Add to dashboard Cite

To survey Canadian health care professionals about their willingness to offer elective cesarean delivery and to evaluate how their knowledge of obstetric-related pelvic-floor injury influences their practice. A voluntary questionnaire was distributed to health care professionals attending the 58th Annual Meeting of the Society of Obstetricians and Gynaecologists of Canada in 2002. Appropriate statistical analysis was used. One hundred and sixty-two questionnaires were completed. One hundred respondents were female (62%). Twenty-three percent (37/162) of respondents approved elective cesarean delivery after informed request in nulliparous women without an obstetrical indication. Males were more likely than females to perform cesarean delivery in these circumstances (34% versus 16%; OR 2.7, CI 1.2, 6.0). When questioned about the impact of mode of delivery on bladder and bowel continence, the number of respondents who answered "usually" or "always has a detrimental effect" were: vaginal birth, 16%; forceps, 20%; and cesarean delivery "reduces bladder and bowel problems", 44%. Males were more likely to emphasize a protective effect of cesarean delivery (55% versus 38%; OR 1.9, CI 1.0, 4.0). Health care professionals would opt for cesarean delivery for themselves when forceps delivery was the alternative more often than they would offer cesarean delivery to their patients (OR 1.98, CI 1.1, 3.5). While a significant number of women's health care professionals are prepared to offer cesarean delivery to nulliparous women, informed choice seems to motivate the offer rather than a conviction that cesarean delivery will protect the pelvic floor.

show abstract

“…1 However, most studies of urinary incontinence are flawed by follow-up limited to 3 to 6 months [2][3][4][5] and fail to specify the difference between minor and severe incontinence. Population-based studies report either no difference in urinary incontinence by route of birth 6 or a baseline rate that is high and only somewhat improved by cesarean section.…”

Section: Penny L Lindballementioning

confidence: 99%

Elective cesarean section

Kleín¹

2004

Canadian Medical Association Journal

View full text Add to dashboard Cite

Parturition and Urinary Incontinence in Primiparas

Cited by 55 publications

References 14 publications

Persistent urinary incontinence and delivery mode history: a six‐year longitudinal study

Persistent urinary incontinence and delivery mode history: a six‐year longitudinal study

The choice of elective cesarean delivery in obstetrics: a voluntary survey of Canadian health care professionals

Elective cesarean section

Contact Info

Product

Resources

About