The effect of pregnancy and mode of delivery on the prevalence of urinary and fecal incontinence

McKinnie, Vikki; Swift, Steven; Wang, Wei; Woodman, Patrick J.; O’Boyle, Amy L.; Kahn, Margie A.; Valley, Michael T.; Bland, Deirdre R.; Schaffer, J I.

doi:10.1016/j.ajog.2005.03.056

Cited by 95 publications

(51 citation statements)

References 13 publications

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“…[20][21][22][23][24] Para além disso, a prevalência de IU no pós-parto é significativamente maior quando esses sintomas ocorrem também durante a gravidez, tal como foi demonstrado pelo estudo de Martin-Martin S et al 25 Historicamente, o parto vaginal tem sido associado a um aumento do risco de IU, devido à lesão do nervo pudendo interno. 26,27 Contudo, estudos mais recentes demonstraram que a cesariana não diminui o risco de IU comparativamente ao parto vaginal. [27][28][29] Através dos resultados do presente estudo pode verificar-se uma diferença estatisticamente significativa entre o tipo de parto e a ocorrência de IU nos dois grupos de mulheres, com e sem IU na gravidez.…”

Section: Discussionunclassified

“…26,27 Contudo, estudos mais recentes demonstraram que a cesariana não diminui o risco de IU comparativamente ao parto vaginal. [27][28][29] Através dos resultados do presente estudo pode verificar-se uma diferença estatisticamente significativa entre o tipo de parto e a ocorrência de IU nos dois grupos de mulheres, com e sem IU na gravidez. No entanto, a multiparidade poderá constituir um fator confundidor, uma vez que no grupo de mulheres primíparas, apesar de menor dimensão, tal associação já não se verifica.…”

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Avaliação da Incontinência Urinária na Gravidez e no Pós-Parto: Estudo Observacional

et al. 2017

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RESUMOIntrodução: A incontinência urinária pode afetar até 50% das mulheres em alguma fase das suas vidas, nomeadamente durante a gravidez. Este estudo foi desenhado com a finalidade de identificar e avaliar a prevalência e fatores de risco para incontinência urinária durante o terceiro trimestre da gravidez e três meses após o parto. No total (n = 237), 51,89% das mulheres incluídas no estudo, relataram a ocorrência de incontinência urinária durante a gravidez. A prevalência da incontinência urinária na gravidez, segundo a paridade (primíparas versus multíparas), foi estatisticamente significativa (p = 0,006). No pós-parto (n = 237), 28,69% das mulheres com incontinência urinária tiveram parto vaginal e 5,91% das mulheres foram submetidas a cesariana (p = 0,001). Neste grupo de mulheres com incontinência urinária pós-parto (n = 82), 31,69% apresentaram incontinência urinária de novo e 68,31% das mulheres já apresentavam sintomatologia durante a gravidez (p < 0,001). Discussão: Este estudo demonstra a elevada prevalência da incontinência urinária na gravidez e a respetiva redução no pós-parto. Conclusão:A multiparidade e a ocorrência de incontinência urinária na gravidez surgem como possíveis fatores de risco no aparecimento da incontinência urinária. Palavras-chave: Complicações na Gravidez; Gravidez; Incontinência Urinária; Período Pós-Parto ABSTRACT Introduction:The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Material and Methods:Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire -Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Results: Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p < 0.001)....

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Avaliação da Incontinência Urinária na Gravidez e no Pós-Parto: Estudo Observacional

et al. 2017

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“…Incontinence rates have not been correlated with delivery method, but elective cesarean sections without attempting labor have been associated with a significantly lower prevalence of postpartum urinary incontinence. 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.…”

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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“…This result supports the theory that full-term pregnancy alone can be the cause for UI. Vikki et al 20 in their polycentric study involving 1004 cases, studying the effects of full-term pregnancy and delivery method on urinary and fecal incontinence, report that pregnancy alone can increase the risk of UI and fecal incontinence; yet comparing c-section and vaginal delivery, they reported that csection does not reduce the risk of UI compared to vaginal delivery. In 15.21% of the cases DM was existent and the incontinence types in these cases were monitored in similar rates.…”

Section: Discussionmentioning

confidence: 99%

Urinary incontinence and risk factors

Yaz¹,

Kurt²,

Demirtaş³

et al. 2015

Cumhuriyet Med J

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SUMMARYObjective: Examining the effects of body mass index (BMI), parity, method of delivery, defects in pelvic floor, diabetes mellitus on the types of incontinence in Urinary incontinence (UI) cases. Method: 230 UI cases were evaluated in this study. Questions asked to the cases to determine the age, parity and the type of incontinence. Incontinence was diagnosed with history. Additionally, gynecological examination findings, fasting and postprandial blood glucose (FBG-PPG) and hemoglobin A1c(HbA1c) levels were recorded. Results: The average age was 49.63 ± 10.68; gravida 4.21 ± 2.68; parity 3.59 ± 2.51. The average BMI was determined as 29.86 ± 4.25. In 94 (40.86%) of the patients had stress incontinence(SUI), 70 (30.43%) urge incontinence(UUI) and 66 (28.69%) mixed incontinence. Pelvic floor defects was detected at 94(40.86%) of the cases. Whereas SUI was observed more prominently in juvenile cases with low parity accompanied by anatomic pelvic deformity; the divergence disappears with the introduction of no pelvic floor defect and with 5 or more instances of gestation and delivery. In 114 (49.56%) cases obesity + morbid obesity was existent. In this group, the types of incontinence were similar; in 116 (51.44%) of the cases with normal weight, SUI was more prevalent. It was observed that there was impaired fasting glucose(IFG) in 68 (29.56%) of cases impaired glucose tolerance(IGT) in 49 (21.30%) of cases and diabetes mellitus in 35 (15.21%) of cases. In IGT cases, SUI was more prevalent. UUI was observed more frequently than MUI and SUI in diabetes cases; however the divergence didn't bear any statistical significance (p>0.05). Conclusion: SUI is prevalent in juvenile cases with IFG and IGT, low parity and delivery, anatomic defects due to traumatic birth. The divergence disappears with advanced age, high parity and delivery. MUI is observed with advanced age more frequently. UUI is observed more frequently in advanced age patient with DM.Keywords: Impaired glucose tolerance, urinary incontinence, risk factors ÖZET Amaç: Üriner inkontinanslı hastalarda vücut kitle indeksi, parite, doğum şekli, pelvik taban defektleri ve gizli veya aşikar diabetin inkontinans tiplerinin dağılımı üzerindeki etkisinin araştırılması. Yöntem: Toplam 230 üriner inkontinans olgusu değerlendirildi. Olgulara; yaş, gebelik, parite, Diabetes Mellitus(DM), gestasyonel diabet ve inkontinans tipini saptamaya yönelik soru formları dolduruldu. Ayrıca boy, kilo, jinekolojik muayene bulguları, açlık-tokluk kan şekeri (AKŞ-TKŞ) ve hemoglobin A1c(HbA1c) ölçümleri değerlendirildi. Bulgular: Olgularda ortalama yaş 49,63 ± 10,68; gravida 4,21 ± 2,68; parite 3,59 ± 2,51; vücut kitle indeksi (VKİ) ortalaması 29,86 ± 4,25 saptanmıştır. Olguların %40,9'unda (94) stres, %30,4'ünde (70) urge, %28,7'sinde (66) mikst inkontinans saptanmıştır. Pelvik taban bozukluğu 94 (%40,86) olguda tespit edildi. Pelvik anatomik bozuklukların eşlik ettiği, genç yaş, düşük parite ve doğumda stres üriner inkontinans (SUİ) baskınlığı ön plandayken; pelvik taban defekti o...

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The effect of pregnancy and mode of delivery on the prevalence of urinary and fecal incontinence

Cited by 95 publications

References 13 publications

Avaliação da Incontinência Urinária na Gravidez e no Pós-Parto: Estudo Observacional

Avaliação da Incontinência Urinária na Gravidez e no Pós-Parto: Estudo Observacional

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

Urinary incontinence and risk factors

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