Vaginal Delivery Doubles the Risk of Stress Incontinence

“Stress incontinence and vaginal delivery. The Scandinavian countries have valid databases of the health of their population. Distances are not far; more people continue to return for follow-up. This is a review of 16 studies. The data is analyzed to evaluate stress incontinence incidence and any correlation with vaginal delivery. There is a correlation. The important part of the commentary is listing the increased complications for the baby of delivery by C-section. They emphasize that the operations now to cure stress incontinence are minor compared to the invasive surgery of a Caesarian section.” bill Chesnut, MD

Vaginal Delivery Doubles the Risk of Stress Incontinence Compared With C-Section  February 23, 2016

HELSINKI, Finland — February 23, 2016 — According to a meta-analysis published in the journal European Urology, vaginal delivery doubles the risk of stress incontinence compared with caesarean section.

The meta-analysis included 16 studies, 8 of which focused on the impact of the mode of delivery on stress incontinence, 7 on the mode of delivery on both stress and urgency incontinence, and 1 on urgency incontinence.

The most common comparison was between vaginal delivery and caesarean section (15 studies that included a total of 45,659 women examining impact on stress incontinence and 8 studies including a total of 49,623 examining impact on urgency incontinence). Four studies compared the effect of operative vaginal delivery and spontaneous vaginal delivery on stress incontinence.

According to the meta-analysis, vaginal delivery is associated with an almost 2-fold increase in the risk of stress urinary incontinence, with an absolute risk increase of 8%, when compared with caesarean section. The effect was larger in younger women and decreased as time passes from the delivery.

Compared with caesarean section, vaginal delivery was also associated with increased risk of urgency incontinence, but with an absolute risk increase of only 3%.

No difference was found between operative vaginal delivery (vacuum, forceps) and spontaneous vaginal delivery.

“Our meta-analysis provides important information about the causes of urgency and stress urinary incontinence in women, quantify one important aspect of caesarean section, and help women and their physicians make decisions regarding mode of delivery,” said Riikka Tähtinen, Kuopio University Hospital, Kuopio, Finland.

“When choosing the mode of delivery, a variety of factors must be considered,” she said. “A planned caesarean section increases the baby’s risk of needing emergency care and the mother’s risk of developing blood clot, bleeding as well as uterine rupture and placental adhesion disorders in subsequent pregnancies. Our review shows that the delivery mode has impact on the pelvic floor health.”

“In the future, it would be useful to identify better those women who are at high risk of developing these problems and to take this better into consideration when deciding their delivery mode,” said Kari Tikkinen, Helsinki University Hospital, Helsinki, Finland. “However, childbirth should not be unnecessarily medicalised, and we should bear in mind that the operation for stress incontinence is smaller and less invasive than caesarean section.”  SOURCE: University of Helsinki

Vaginal Delivery Doubles the Risk of Stress Incontinence Compared With C-Section

February 23, 2016

HELSINKI, Finland — February 23, 2016 — According to a meta-analysis published in the journal European Urology, vaginal delivery doubles the risk of stress incontinence compared with caesarean section.

The meta-analysis included 16 studies, 8 of which focused on the impact of the mode of delivery on stress incontinence, 7 on the mode of delivery on both stress and urgency incontinence, and 1 on urgency incontinence.

The most common comparison was between vaginal delivery and caesarean section (15 studies that included a total of 45,659 women examining impact on stress incontinence and 8 studies including a total of 49,623 examining impact on urgency incontinence). Four studies compared the effect of operative vaginal delivery and spontaneous vaginal delivery on stress incontinence.

According to the meta-analysis, vaginal delivery is associated with an almost 2-fold increase in the risk of stress urinary incontinence, with an absolute risk increase of 8%, when compared with caesarean section. The effect was larger in younger women and decreased as time passes from the delivery.

Compared with caesarean section, vaginal delivery was also associated with increased risk of urgency incontinence, but with an absolute risk increase of only 3%.

No difference was found between operative vaginal delivery (vacuum, forceps) and spontaneous vaginal delivery.

“Our meta-analysis provides important information about the causes of urgency and stress urinary incontinence in women, quantify one important aspect of caesarean section, and help women and their physicians make decisions regarding mode of delivery,” said Riikka Tähtinen, Kuopio University Hospital, Kuopio, Finland.

“When choosing the mode of delivery, a variety of factors must be considered,” she said. “A planned caesarean section increases the baby’s risk of needing emergency care and the mother’s risk of developing blood clot, bleeding as well as uterine rupture and placental adhesion disorders in subsequent pregnancies. Our review shows that the delivery mode has impact on the pelvic floor health.”

“In the future, it would be useful to identify better those women who are at high risk of developing these problems and to take this better into consideration when deciding their delivery mode,” said Kari Tikkinen, Helsinki University Hospital, Helsinki, Finland. “However, childbirth should not be unnecessarily medicalised, and we should bear in mind that the operation for stress incontinence is smaller and less invasive than caesarean section.”

SOURCE: University of Helsinki