Stress urinary incontinence 4 years after the first delivery: a retrospective cohort survey

Fritel, Xavier; Fauconnier, Arnaud; Levet, Caroline; Bénifla, Jean-Louis

doi:10.1111/j.0001-6349.2004.00457.x

Cited by 71 publications

(55 citation statements)

References 37 publications

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“…Fritel et al, in their study showed that cesarean was significantly associated with a lower risk of SUI compared to normal delivery. 24 It is not known whether by increasing the number of caesarean sections, the incidence of SUI could be decreased. Even reverse can be considered true that, women requiring cesarean have more inflexible connective tissue (lower incidence of SUI), leading to delayed cervical dilatation, requiring surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of urinary incontinence in reproductive women and its impact on quality of life

Poomalar

Priyadharshini

2015

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Prevalence of urinary incontinence in reproductive women and its impact on quality of life

Poomalar

Priyadharshini

2015

Int J Reprod Contracept Obstet Gynecol

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“…5 Epidemiological studies indicate that risk factors for UI are age, parity, previous pelvic or perineal surgery, obesity and chronic diseases. [6][7][8][9][10][11] More recently, a report that major depression may be involved in the onset of UI has opened up the field to new pathophysiological hypotheses.…”

Section: Introductionmentioning

confidence: 99%

Incidence and remission of urinary incontinence at midlife: a cohort study

Legendre

Ringa

Panjo

et al. 2014

BJOG

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Objective Urinary incontinence (UI) is often considered to be an age-related disease that develops gradually as women grow older. Much remains to be learnt about factors that promote its incidence or its remission. Our objective was to assess its incidence and risk factors.Design Longitudinal cohort study.Setting French GAZEL cohort.Population A cohort of 4127 middle-aged women (aged 47-52 years at baseline) over an 18-year period (1990-2008).Methods UI was defined as 'difficulty retaining urine'. The question was asked at baseline and repeated every 3 years over an 18-year period. Two groups (UI incidence and remission) were analysed according to status at baseline (continent or incontinent). A multivariable analysis (Cox model) was used to estimate the risk factors for UI incidence and remission.Main outcome measures Annual incidence and remission rates and risk factors for UI incidence and remission.Results The annual incidence and remission rates for UI were 3.3% and 6.2%, respectively. High educational level (hazard ratio[HR] = 1.28; 95% confidence interval [95% CI] = 1.05-1.55), parity, i.e. at least one baby versus no baby (HR = 1.64; 95% CI = 1.19-2.27), menopause (HR = 5.44; 95% CI = 4.47-6.63), weight gain, i.e. for each kilogram change in weight (HR = 1.00; 95% CI = 1.00-1.02), onset of depressive symptoms (HR = 1.31; 95% CI = 1.09-1.57) and impairment in health-related quality of life incidence (social isolation dimension [HR = 1.29; 95% CI = 1.04-1.60] and energy dimension [HR = 1.41; 95% CI = 1.17-1.70]) were associated with an increased probability of UI. The factors associated with persistent UI were age (HR = 0.58; 95% CI = 0.55-0.61), weight gain (HR = 0.99; 95% CI = 0.98-0.99) and transition to menopausal status (HR = 1.54; 95% CI = 1.19-1.99).Conclusions Our study suggests that, in our population of middleaged women, age, menopause, weight gain, onset of depression and impaired health-related quality of life may promote UI.

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“…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. 9 In women without urinary incontinence, the pelvic floor muscles contract simultaneously with or immediately before increases in abdominal pressure as an unconscious involuntary automatic co-contraction.…”

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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Stress urinary incontinence 4 years after the first delivery: a retrospective cohort survey

Abstract: Our results suggest that stress urinary incontinence after pregnancy arises from a multifactorial condition. The main risk factors are: age, previous incontinence (before or during the first pregnancy), prolonged labor and vaginal delivery.

Cited by 71 publications

References 37 publications

Prevalence of urinary incontinence in reproductive women and its impact on quality of life

Prevalence of urinary incontinence in reproductive women and its impact on quality of life

Incidence and remission of urinary incontinence at midlife: a cohort study

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

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