Authors:El-Sokkary M.(MD), Wahba K. (MD),El-Shahawy Y.(MD), Fathy H.(MD), El-Shourbagy M.(MD), Raouf R

Abstract

To retrospectively assess the relationship between female stress urinary incontinence (SUI) and mode of delivery and to evaluate whether vaginal delivery increases the risk of subsequent urinary incontinence or not.  It was a case-series study that was done at Ain Shams University Maternity Hospital and included women who were admitted to Ain Shams University Maternity Hospital, for having stress urinary incontinence, over a 5-year period, between January 2005 and December 2009.  A second group of matched women, with no complaint of SUI and came to outpatient clinic for reasons other than urinary incontinence, were included as a control group. Data was collected from patient records available at “Patient Records Department” at Ain-Shams University Maternity Hospital. Missing data was collected through phone calls or direct contact with the patients or their relatives. This study included 2 groups of women: group I (study group) [n=80]: women who were admitted for having a complaint of SUI, and group II (control group) [n=80]: women with no complaint of SUI and came to outpatient clinic for reasons other than urinary incontinence.  There was a significantly higher proportion of vaginal deliveries and a significantly lower proportion of Cesarean sections among women who had stress urinary incontinence, when compared to women of the control group [66/80 (82.5%) vs. 41/80 (51.3%) and 14/80 (17.5%) vs. 39/80 (48.7%), respectively, p<0.001]. The prevalence of operative vaginal delivery was significantly higher among women who had stress urinary incontinence when compared to women of the control group [9/66 (13.6%) vs. 0/41 (0%), respectively, p=0.04].  The prevalence of urgent Cesarean sections was significantly higher among women who had stress urinary incontinence when compared to women of the control group [8/14 (57.1%) vs. 1/39 (2.6%), respectively, p=0.03] Of the included 80 women who had stress urinary incontinence, 47 (58.7%) women had stress urodynamic type, 6 (7.5%) had detrusor instability, while 27 (33.8%) had mixed type of stress urinary incontinence. There was a significantly higher proportion of vaginal deliveries among women who had stress urodynamic or mixed type of urinary incontinence, when compared to women who had detrusor instability [41/47 (87.2%) vs. 22/27 (81.5%) vs. 3/6 (50%), respectively, p=0.001] There was a significantly higher proportion of women who had operative vaginal delivery among women who had urodynamic stress urinary incontinence, when compared to women who had detrusor instability or mixed type [9/41 (21.9%) vs. 0/3 (0%) vs. 0/22 (0%), respectively, p=0.04] There were significant positive correlations between stress urinary incontinence and vaginal delivery [r= 0.297, p<0.001].

Keywords

 Stress urinary incontinence – mode of delivery

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Relationship between Female Urinary Incontinence and Mode of Delivery