The risk of stress incontinence 5 years after first delivery

ArticleinAmerican Journal of Obstetrics and Gynecology 185(1):82-7 · August 2001with6 Reads
DOI: 10.1067/mob.2001.114501 · Source: PubMed
We aimed to evaluate the impact of a first pregnancy and delivery on the prevalence of stress incontinence 5 years afterward. This longitudinal cohort study included 278 women who were questioned after their first delivery and again 5 years later. The prevalence of stress incontinence 5 years after a first delivery was 30%, and the 5-year incidence was 19%. The risk of stress incontinence 5 years after a first delivery was related to the onset and duration of symptoms after the first pregnancy and delivery in a "dose-response-like" manner. The use of vacuum extraction or episiotomy during the first delivery increased the risk. First pregnancy and delivery may result in stress incontinence 5 years later. Women with incontinence 3 months after a first delivery have a particularly high risk of long-lasting symptoms. Obstetric risk factors are vacuum extraction and episiotomy.
    • "Superiority of clinical evaluation over urodynamic study is more obvious in urge and mixed UIs. This data is contradictory to data in relevant literature [5,13,14]. This may be attributed to the fact that most of these publications are based on comparison of medical history and urodynamic study. "
    Full-text · Article · May 2016 · Journal of Maternal-Fetal and Neonatal Medicine
    • "Potential associations between pelvic floor disorders and type of delivery have been the subject of numerous recent and current obstetrical and urogynecological investigations. Pelvic floor disorder can lead to urinary incontinence [1, 2, 3], descent and prolapse of the pelvic organs, and fecal incontinence [1, 3, 4, 5]. In addition to delivery, other known risk factors include increased age of the woman in labor, parity, excess weight, and increased physical exertion [6, 7]. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: We compared the incidence and type of levator ani avulsion diagnosed by translabial ultrasound evaluation in primiparous women six months after vacuum-assisted or spontaneous vaginal delivery. Material and methods: This retrospective observational study was performed between January 2011 and December 2013. Primiparous women six months after vacuum-assisted vaginal delivery and after spontaneous vaginal delivery underwent translabial ultrasound evaluation. The distance between the urethra and fibers of the musculus levator ani puborectalis (levator–urethra gap) was measured. A levator-urethra gap >25 mm was considered a musculus levator ani avulsion. Results: In total, 184 women participated in the study. Among them, 92 had vacuum extraction and 92 had uncomplicated spontaneous delivery. A longer levator–urethra gap on both sides of the pubic bone was found in women after vacuum-assisted vaginal delivery (p < 0.0001 for both sides). Musculus levator ani avulsion was identified in 20 women (unilateral in 16 cases and bilateral in four cases). No difference in an incidence of musculus levator ani avulsion was identified in women after vacuum-assisted vaginal delivery [11/92 (12%)] compared to spontaneous delivery [9/92 (10%); p = 0.81]. Conclusion: Vacuum-assisted vaginal delivery in primiparous women is associated with a longer levator–urethra gap but not with a higher frequency of avulsion of the musculus levator ani.
    Full-text · Article · Oct 2015
    • "ls, ATM Bernards, RA de Bie, and HCW de Vet. Critical revision of the manuscript for important intellectual content: EJM Hendriks, AGH Kessels, ATM Bernards, HCW de Vet, and RA de Bie. Statistical analysis: EJM Hendriks, AGH Kessels, and HCW de Vet. Obtained funding: EJM Hendriks. **Health Scientist, Epidemiologist, Senior Researcher, and Lecturer. 19,20 Episiotomy has not been found to increase the risk of stress UI, nor does it seem protective, 14 but is generally considered a risk factor for fecal incontinence . 13 Women who developed stress UI during pregnancy or after childbirth were also found to be at risk for long-term stress UI. 19 There is also support from the literature fo"
    Full-text · Dataset · Aug 2015 · Journal of Maternal-Fetal and Neonatal Medicine
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