Prevalence of diastasis recti abdominis in postmenopausal women with stress urinary incontinence: An observational study

Abstract

Purpose: To determine the prevalence of diastasis recti abdominis (DRA) in postmenopausal women with stress urinary incontinence (SUI). Methods: 385 postmenopausal women complaining of SUI joined the study from Maghagha General Hospital/ El-Minia, Egypt. Their age ranged from 45-60 years and their body mass index (BMI) ranged from 25-35 kg/m 2 . Only women with proven SUI, confirmed by cough stress test, were included in the study. Demographic data for each woman, including BMI, waist/hip ratio, (WHR), and the years since the last menstrual cycle were recorded. The magnitude and frequency of the urine loss were recorded through a set of questions. The measurements of inter-rectus distance were done by finger width test and abdominal ultrasonography. DRA identification was based on the presence of separation ≥ 20 mm at any level (supra umbilical / umbilical) in abdominal ultrasonography. Results: Only 200 postmenopausal women were included out of 385 women. The prevalence of DRA among postmenopausal women with SUI was 79.5% (95% Confidence interval (CI) of 73.37-84.51%) based on abdominal ultrasonography. There was a significant increase (p = 0.006)* in the prevalence of DRA in obese compared to overweight patients, and in patients with a WHR of 0.97-1.3, compared to patients with a WHR of 0.82-0.96 (p = 0.02)*. There was no significant association (p = 0.56) between DRA and the years since last menstrual cycle. Regarding SUI parameters, there was a statistically significant association (P<0.05) of DRA with both the amount of urine loss (p = 0.001)* and the times of involuntary loss of urine (p = 0.001)*. Conclusion: DRA appears to be prevalent in Egyptian postmenopausal women with SUI. Also, DRA prevalence could be affected by the patient's BMI and WHR.