What factors are predictive of urinary continence following pregnancy?

Abstract

Introduction:

The growing pregnant uterus exerts increasing pressure on the pelvic floor as pregnancy advances and in addition hormonal changes influence muscle and connective tissue function. Vaginal delivery may cause pelvic floor damage by several mechanisms such as muscle trauma, connective tissue damage, nerve injury and vascular damage. Thus, it is perhaps not surprising that pregnancy and in particular vaginal birth have been proposed as important risk factors for urinary incontinence (UI) and other forms of pelvic floor dysfunction such as pelvic organ prolapse and fecal incontinence

Purpose of this review:

The aim of this review was to summarize our current knowledge regarding pregnancy and childbirth as important risk factors for urinary incontinence.

Summary:

Urinary incontinence is more common in women than men and there is strong epidemiological evidence demonstrating an increased prevalence of UI during pregnancy. The prevalence of UI is higher in women who had undergone a pregnancy compared to nulliparous women of the same age. The risk of developing UI was higher after vaginal delivery (VD) than after caesarean section (CS) and the prevalence of UI>10 years almost tripled after VD compared to CS.

Maternal body mass index and age and infant birth weight were other important risk factors. Nulliparous women and women who have undergone caesarean-only delivery rarely undergo urinary incontinence surgery.