Journal
INTERNATIONAL UROGYNECOLOGY JOURNAL
Volume 21, Issue 5, Pages 535-544Publisher
SPRINGER LONDON LTD
DOI: 10.1007/s00192-009-1074-8
Keywords
Anal incontinence; Cesarean section; Pelvic organ prolapse; Pregnancy; Prevalence; Urinary incontinence
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Funding
- Newcastle Healthcare Charity, UK
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Intrapartum events at first delivery and subsequent childbearing are associated with long-term pelvic floor dysfunction (PFD). Primigravidae delivered between 1983-1986 were identified; current addresses traced through the UK National Health Service database (N = 3002). Women completed screening and Sheffield Pelvic Floor Questionnaires (Sheffield-PAQ A (c)). Maternity data were obtained from Standard Maternity Information System. Primary outcomes were urinary incontinence (UI), anal incontinence (AI), and prolapse (POP). Primary response was 62.1%; 53.8% (n = 985) had a parts per thousand yen1 PFD symptom and in 71.5% symptoms were bothersome. UI (OR 0.47 95% CI 0.28, 0.81) and fecal incontinence (FI; OR 0.32 95% CI 0.13, 0.77) risks were lower after first delivery by cesarean section (CS). However, 25% had UI and 12% had FI after delivering exclusively by CS. Obesity was a risk factor independent of obstetric history. CS provides incomplete or poorly sustained pelvic floor protection by middle age. Obese women were at highest risk and had the most severe symptoms.
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