nach oben

International Urogynecology Journal

Erschienen in:

02.03.2018 | Original Article

Prevalence and predictors of double incontinence 1 year after first delivery

verfasst von: Hege Hølmo Johannessen, Signe Nilssen Stafne, Ragnhild Sørum Falk, Arvid Stordahl, Arne Wibe, Siv Mørkved

Erschienen in: International Urogynecology Journal | Ausgabe 10/2018

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

Urinary (UI) and anal incontinence (AI) are common pelvic floor disorders (PFD), and postpartum women experiencing double incontinence (DI), the combination of UI and AI, tend to have more severe symptoms and a greater impact on quality of life. Our objective was to investigate the prevalence and predictors of postpartum DI and UI alone 1 year after first delivery.

Methods

In this prospective cohort study, 976 women reported the prevalence of DI and UI alone 1 year after their first delivery in one of two hospitals in Norway using the St Marks score and the ICI-Q UI SF.

Results

DI was significantly reduced from 13% in late pregnancy to 8% 1 year later, whereas 30% reported UI at both time points. Incontinence in late pregnancy predicted incontinence 1 year after delivery. Higher age was associated with UI alone. Compared with caesarean delivery, normal vaginal or instrumental delivery increased the risk of UI alone more than three and four times respectively. Obstetric anal sphincter injuries showed a four-fold increase in the risk of DI.

Conclusions

Nearly 50% reported incontinence symptoms 1 year after first delivery. Continence status during pregnancy was one of the main predictors of postpartum continence status. Mode of delivery increased the risk of postpartum UI, whereas obstetric anal sphincter injuries increased the risk of postpartum DI.

Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6.CrossRef

Delancey JO, Kane Low L, Miller JM, Patel DA, Tumbarello JA. Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. Am J Obstet Gynecol. 2008;199(6):610.e1–5. https://doi.org/10.1016/j.ajog.2008.04.001.CrossRef

Wesnes SL, Lose G. Preventing urinary incontinence during pregnancy and postpartum: a review. Int Urogynecol J. 2013;24(6):889–99.CrossRef

Brown SJ, Gartland D, Donath S, MacArthur C. Fecal incontinence during the first 12 months postpartum: complex causal pathways and implications for clinical practice. Obstet Gynecol. 2012;119(2 Pt 1):240–9. https://doi.org/10.1097/AOG.0b013e318242b1f7.CrossRefPubMed

Guise JM, Morris C, Osterweil P, Li H, Rosenberg D, Greenlick M. Incidence of fecal incontinence after childbirth. Obstet Gynecol. 2007;109(2 Pt 1):281–8. https://doi.org/10.1097/01.AOG.0000254164.67182.78.CrossRefPubMed

Geynisman-Tan JM, Taubel D, Asfaw TS. Is something missing from antenatal education: a survey of pregnant women’s knowledge of pelvic floor disorders. Female Pelvic Med Reconstr Surg. 2017; https://doi.org/10.1097/SPV.0000000000000465 .CrossRefPubMed

Hill A-M, McPhail SM, Wilson JM, Berlach RG. Pregnant women’s awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey. Int Urogynecol J. 2017;28(10):1557–65.CrossRef

Tucker J, Grzeskowiak L, Murphy EMA, Wilson A, Clifton VL. Do women of reproductive age presenting with pelvic floor dysfunction have undisclosed anal incontinence: a retrospective cohort study. Women Birth. 2017;30(1):18–22.CrossRef

Avery KN, Bosch JL, Gotoh M, Naughton M, Jackson S, Radley SC, et al. Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol. 2007;177(1):39–49. https://doi.org/10.1016/j.juro.2006.08.075.CrossRefPubMed

10.

Espuna-Pons M, Solans-Domenech M, Sanchez E, Pelvic Floor Research Group. Double incontinence in a cohort of nulliparous pregnant women. Neurourol Urodyn. 2012;31(8):1236–41. https://doi.org/10.1002/nau.22249.CrossRefPubMed

11.

Fialkow MF, Melville JL, Lentz GM, Miller EA, Miller J, Fenner DE. The functional and psychosocial impact of fecal incontinence on women with urinary incontinence. Am J Obstet Gynecol. 2003;189(1):127–9. https://doi.org/10.1067/mob.2003.548.CrossRefPubMed

12.

Johannessen HH, Wibe A, Stordahl A, Sandvik L, Backe B, Morkved S. Prevalence and predictors of anal incontinence during pregnancy and 1 year after delivery: a prospective cohort study. Br J Obstetr Gynaecol. 2014;121(3):269–79. https://doi.org/10.1111/1471-0528.12438.CrossRef

13.

Vaizey CJ, Carapeti E, Cahill JA, Kamm MA. Prospective comparison of faecal incontinence grading systems. Gut. 1999;44(1):77–80.CrossRef

14.

Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20. https://doi.org/10.1002/nau.20798.CrossRefPubMed

15.

Hatem M, Pasquier J-C, Fraser W, Lepire E. Factors associated with postpartum urinary/anal incontinence in primiparous women in Quebec. J Obstet Gynaecol Can. 2007;29(3):232–9. https://doi.org/10.1016/S1701-2163(16)32402-1.CrossRefPubMed

16.

Brown S, Gartland D, Perlen S, McDonald E, MacArthur C. Consultation about urinary and faecal incontinence in the year after childbirth: a cohort study. BJOG. 2015;122(7):954–62.CrossRef

17.

Viktrup L, Rortveit G, Lose G. Does the impact of subsequent incontinence risk factors depend on continence status during the first pregnancy or the postpartum period 12 years before? A cohort study in 232 primiparous women. Am J Obstet Gynecol. 2008;199(1):73.e71-73.e74. https://doi.org/10.1016/j.ajog.2007.11.069.CrossRefPubMed

18.

Burgio KL, Zyczynski H, Locher JL, Richter HE, Redden DT, Wright KC. Urinary incontinence in the 12-month postpartum period. Obstet Gynecol. 2003;102(6):1291–8.PubMed

19.

Slieker-ten Hove MCP, Pool-Goudzwaard AL, Eijkemans MJC, Steegers-Theunissen RPM, Burger CW, Vierhout ME. Prevalence of double incontinence, risks and influence on quality of life in a general female population. Neurourol Urodyn. 2010;29(4):545–50. https://doi.org/10.1002/nau.20760.CrossRefPubMed

20.

Kapoor DS, Thakar R, Sultan AH. Combined urinary and faecal incontinence. Int Urogynecol J. 2005;16(4):321–8. https://doi.org/10.1007/s00192-004-1283-0.CrossRef

21.

Lo J, Osterweil P, Li H, Mori T, Eden KB, Guise JM. Quality of life in women with postpartum anal incontinence. Obstet Gynecol. 2010;115(4):809–14. https://doi.org/10.1097/AOG.0b013e3181d4160d.CrossRefPubMed

22.

Wei JT, Dunn R, Nygaard I, Burgio K, Lukacz ES, Markland A, et al. Development and validation of a quantitative measure of adaptive behaviors in women with pelvic floor disorders. Female Pelvic Med Reconstr Surg. 2017;23(4):232–7.CrossRef

23.

Boreham MK, Richter HE, Kenton KS, Nager CW, Gregory WT, Aronson MP, et al. Anal incontinence in women presenting for gynecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol. 2005;192(5):1637–42. https://doi.org/10.1016/j.ajog.2004.11.030.CrossRefPubMed

24.

Johannessen HH, Norderval S, Stordahl A, Falk RS, Wibe A. Interview-based versus self-reported anal incontinence using St Mark’s incontinence score. Int Urogynecol J. 2017; https://doi.org/10.1007/s00192-017-3363-y.CrossRef

25.

Richter HE, Burgio KL, Clements RH, Goode PS, Redden DT, Varner RE. Urinary and anal incontinence in morbidly obese women considering weight loss surgery. Obstet Gynecol. 2005;106(6):1272–7. https://doi.org/10.1097/01.AOG.0000187299.75024.c4.CrossRefPubMed

26.

Wesnes SL, Hunskaar S, Bo K, Rortveit G. Urinary incontinence and weight change during pregnancy and postpartum: a cohort study. Am J Epidemiol. 2010;172(9):1034–44.CrossRef

27.

American College of Obstetricians and G. ACOG Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol. 2013;121(1):210–2. https://doi.org/10.1097/01.AOG.0000425668.87506.4c.CrossRef

28.

The International Weight Management in Pregnancy (i-WIP) Collaborative Group. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ. 2017;358:j3119. https://doi.org/10.1136/bmj.j3119.CrossRef

29.

Boyle R, Hay-Smith EJ, Cody JD, Morkved S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;10:CD007471. https://doi.org/10.1002/14651858.CD007471.pub2.CrossRefPubMed

30.

Johannessen HH, Wibe A, Stordahl A, Sandvik L, Morkved S. Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial. BJOG. 2016;124(4):686–94. https://doi.org/10.1111/1471-0528.14145.CrossRefPubMed

Titel: Prevalence and predictors of double incontinence 1 year after first delivery
verfasst von: Hege Hølmo Johannessen
Signe Nilssen Stafne
Ragnhild Sørum Falk
Arvid Stordahl
Arne Wibe
Siv Mørkved
Publikationsdatum: 02.03.2018
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 10/2018
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-018-3577-7

Neu im Fachgebiet Gynäkologie und Geburtshilfe

17.04.2024 | Postoperative nausea and vomiting | Nachrichten

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Prevalence and predictors of double incontinence 1 year after first delivery

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Hochrisiko-Eingriffe für postoperative Übelkeit

Adjuvante Brustkrebstherapie: Doppelt hält besser

Manche Gestagene können das Risiko für Meningeome erhöhen

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Gynäkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2018

Laparoscopic management of severe ureteral obstruction after vaginal hysterectomy and colposuspension

Clinical and ultrasonographic evaluation of the pelvic floor in primiparous women: a cross-sectional study

Evaluation of intra-individual test–re-test variability of uroflowmetry in healthy women and women suffering from stress, urge, and mixed urinary incontinence

Impact of subsequent pregnancies on pelvic floor functional anatomy

Could the correct side of mediolateral episiotomy be determined according to anal sphincter EMG?

A blinded observational cohort study of the microbiological ecology associated with pyuria and overactive bladder symptoms

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Hochrisiko-Eingriffe für postoperative Übelkeit

Adjuvante Brustkrebstherapie: Doppelt hält besser

Manche Gestagene können das Risiko für Meningeome erhöhen

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Gynäkologie