Stress incontinence during pregnancy and in puerperium

Abstract

A retrospective follow-up investigation dealing with the frequency of stress incontinence was carried out among maternities at the Women's Clinic in Lund over a period of 15 months. Of 1400 newly-delivered women whose interviews were solicited, 1411 responded. Twenty-two percent indicated symptoms of stress incontinence. These were examined gynecologically, including Bonney's test. The material may be divided into four groups according to the onset and type of stress incontinence:--Onset of stress incontinence prior to pregnancy in connection with puberty: 8.5% of the total number of stress incontinents (2% of th entire material). -- Permanent stress incontinence with onset during pregnancy; 23% of all stress incontinents (5% of the entire material). --Temporary, mild, "physiological" stress incontinence, manifest only during the second part of the pregnancy and disappearing approximately 3 months after delivery. This type of incontinence represents 50% of all stress incontinence (11% of the entire material). --Stress incontinence arising in conjunction with or following parturition; 19% of all cases of stress incontinence (4% of the entire material). Of the patients in this group 8% were temporarily incontinent. Eleven percent (2.3% of the entire material), represents women suffering from constant incontinence which first appeared in connection with childbirth. It is more often the case that stress incontinence begins during the first pregnancy rather than during subsequent pregnancies (statistical significance P less than or equal to 0.05). The results indicate that the pregnancy itself and hereditary factors predispose more readily than the parturition trauma to the occurrence of stress incontinence.

Epidemiology of Urinary Incontinence in Pregnancy and Postpartum

“…The use of a research nurse to clarify and complete the questionnaire with each participant might explain the high incidence. Several Scandinavian cohort studies have reported incidence of UI postpartum; in the 30 year old Swedish cohort of 1,411 primiparous women, 19 % reported incident stress UI 6 months post partum (Iosif, 1981). Wesnes et al found a similar incidence of any UI 6 months postpartum (21 %) among 12,679 primiparous women who were continent before pregnancy (Wesnes et al, 2009).…”

“…Prevalence of UI postpartum is a so called "mixed bag" of incident UI before pregnancy, incident UI in pregnancy and incident UI postpartum (Iosif, 1981, Nygaard, 2006. Risk factors for incident UI at the different time points vary.…”

Prevalence and treatment of post partum urinary incontinence

“…Iosif (34) concluded that onset of incontinence is more often found during the first pregnancy than during subsequent pregnancies. Demonstrating a prevalence of 9% in women delivering with cesarean section, Iosif et al (35) concluded that the pregnancy itself and hereditary factors may predispose more than parturition trauma in some women.…”

Postpartum Incontinence

“…The questionnaire was designed to penetrate the frequency of urinary inconti nence among pregnant women and women recently confined. The results of the survey are shown sepa rately [7], Measurements of the patients were carried out 7-14 days following parturition. 2 of the patients were delivered by cesarean section.…”