Skip to main content
Erschienen in: International Urogynecology Journal 9/2015

01.09.2015 | Original Article

Prevalence and predictors of urinary/anal incontinence after vaginal delivery: prospective study of Nigerian women

verfasst von: Kingsley Chukwu Obioha, Emmanuel Onyebuchi Ugwu, Samuel Nnamdi Obi, Cyril Chukwudi Dim, Theophilus Chimezie Oguanuo

Erschienen in: International Urogynecology Journal | Ausgabe 9/2015

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

Urinary and anal incontinence are major public health problems impacting on the quality of life of affected women, with resultant loss of self-esteem. Despite the anticipated magnitude of this public health problem in sub-Saharan Africa, there is paucity of data on the prevalence of urinary and/or anal incontinence after childbirth in the region. This study determined the prevalence and predictors of urinary and anal incontinence after vaginal delivery among women in Enugu, southeastern Nigeria.

Methods

This was a longitudinal study of 230 consecutive parturients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Eligible women were followed up immediately, 6 weeks, and 3 months postpartum to assess the development of urinary and/or anal incontinence using validated questionnaires.

Results

Overall, 28 women had urinary incontinence, giving a cumulative prevalence rate of 12.2 %. The cumulative prevalence rate was 13.5 % for anal incontinence and 3 % for combined urinary and anal incontinence. Age, social class, parity, prolonged second stage of labor, and neonatal birth weight were significantly associated with postpartum urinary incontinence (P < 0.05). On the other hand, age, parity, prolonged second stage of labor, episiotomy, and instrumental vaginal delivery were significantly associated with postpartum anal incontinence (P < 0.05).

Conclusion

Urinary and anal incontinence are common after vaginal delivery in Enugu, Nigeria. Modification of obstetric care and discouraging preventable predisposing factors for incontinence, such as prolonged second stage of labor and vaginal delivery of macrosomic babies, are measures that may reduce the prevalence of postpartum incontinence in our population.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A, Standardisation Sub-committee of the International Continence Society (2002) The standardization of terminology of lower urinary tract function: report from the standardization sub-committee of the international continence society. Neurourol Urodyn 21:167–178CrossRefPubMed Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A, Standardisation Sub-committee of the International Continence Society (2002) The standardization of terminology of lower urinary tract function: report from the standardization sub-committee of the international continence society. Neurourol Urodyn 21:167–178CrossRefPubMed
2.
Zurück zum Zitat Macmillan AK, Meurie AE, Marshall RJ, Parry BR (2004) The prevalence of fecal incontinence in community dwelling adult: a systematic review of the literature. Dis Colon Rectum 47:1341–1349CrossRefPubMed Macmillan AK, Meurie AE, Marshall RJ, Parry BR (2004) The prevalence of fecal incontinence in community dwelling adult: a systematic review of the literature. Dis Colon Rectum 47:1341–1349CrossRefPubMed
3.
Zurück zum Zitat Hatem M, Pasquier JC, Fraser W, Lepire E (2007) Factors associated with postpartum urinary/anal incontinence in primiparous women in Quebec. J Obstet Gynaecol Can 29:232–239PubMed Hatem M, Pasquier JC, Fraser W, Lepire E (2007) Factors associated with postpartum urinary/anal incontinence in primiparous women in Quebec. J Obstet Gynaecol Can 29:232–239PubMed
4.
Zurück zum Zitat Groutz A, Fait G, Lessing JB, David MP, Wolman I, Jaffa A, Gordon D (1999) Incidence and obstetric risk factors of postpartum anal incontinence. Scand J Gastroenterol 34:315–318PubMed Groutz A, Fait G, Lessing JB, David MP, Wolman I, Jaffa A, Gordon D (1999) Incidence and obstetric risk factors of postpartum anal incontinence. Scand J Gastroenterol 34:315–318PubMed
5.
Zurück zum Zitat Lal M, HMann C, Callender R, Radley S (2003) Does caesarean delivery prevent anal incontinence? Obstet Gynecol 101:305–312CrossRefPubMed Lal M, HMann C, Callender R, Radley S (2003) Does caesarean delivery prevent anal incontinence? Obstet Gynecol 101:305–312CrossRefPubMed
6.
Zurück zum Zitat Gyhagen M, Bullarbo M, Nielsen TF, Milsom I (2013) A comparison of the long-term consequences of vaginal delivery versus caesarean section on the prevalence, severity and bothersomeness of urinary incontinence subtypes: a national cohort study in primiparous women. BJOG 120:1548–1555PubMed Gyhagen M, Bullarbo M, Nielsen TF, Milsom I (2013) A comparison of the long-term consequences of vaginal delivery versus caesarean section on the prevalence, severity and bothersomeness of urinary incontinence subtypes: a national cohort study in primiparous women. BJOG 120:1548–1555PubMed
7.
Zurück zum Zitat Handa VL, Blomquist JL, Knoepp LR, Hoskey KA, McDermott KC, Muñoz A (2011) Pelvic floor disorders 5–10 years after vaginal or cesarean childbirth. Obstet Gynecol 118:777–784PubMedCentralPubMed Handa VL, Blomquist JL, Knoepp LR, Hoskey KA, McDermott KC, Muñoz A (2011) Pelvic floor disorders 5–10 years after vaginal or cesarean childbirth. Obstet Gynecol 118:777–784PubMedCentralPubMed
8.
Zurück zum Zitat Rogers RG, Leeman LM, Borders N, Qualls C, Fullilove AM, Teaf D, Hall RJ, Bedrick E, Albers LL (2007) Contribution of the second stage of labour to pelvic floor dysfunction: a prospective cohort comparison of nulliparous women. J Obstet Gynaecol Can 29:232–239 Rogers RG, Leeman LM, Borders N, Qualls C, Fullilove AM, Teaf D, Hall RJ, Bedrick E, Albers LL (2007) Contribution of the second stage of labour to pelvic floor dysfunction: a prospective cohort comparison of nulliparous women. J Obstet Gynaecol Can 29:232–239
9.
Zurück zum Zitat National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey (2008) Abuja, Nigeria: National Population Commission and ICF Macro National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey (2008) Abuja, Nigeria: National Population Commission and ICF Macro
10.
Zurück zum Zitat Okonkwo JE, Obionu CN, Okonkwo CV, Obiechina NJ (2002) Anal incontinence among Igbo (Nigerian) women. Int J Clin Pract 56:178–180PubMed Okonkwo JE, Obionu CN, Okonkwo CV, Obiechina NJ (2002) Anal incontinence among Igbo (Nigerian) women. Int J Clin Pract 56:178–180PubMed
12.
Zurück zum Zitat Adaji SE, Shittu OS, Bature SB, Nasir S, Olatunji O (2011) Bothersome lower urinary symptoms during pregnancy: a preliminary study using the international consultation on incontinence questionnaire. Afr Health Sci 11(Suppl 1):S46–S52, PMID:22135644PubMedCentralPubMed Adaji SE, Shittu OS, Bature SB, Nasir S, Olatunji O (2011) Bothersome lower urinary symptoms during pregnancy: a preliminary study using the international consultation on incontinence questionnaire. Afr Health Sci 11(Suppl 1):S46–S52, PMID:22135644PubMedCentralPubMed
13.
Zurück zum Zitat Kelly J (1995) Ethiopia: an epidemiological study of vesicovaginal fistulas in Addis Ababa. World Health Stat Q 48:15–17PubMed Kelly J (1995) Ethiopia: an epidemiological study of vesicovaginal fistulas in Addis Ababa. World Health Stat Q 48:15–17PubMed
14.
Zurück zum Zitat Danso KA, Martey JO, Wall LL, Elkins TE (1996) The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992. Int Urogynecol J Pelvic Floor Dysfunct 7:117–120CrossRefPubMed Danso KA, Martey JO, Wall LL, Elkins TE (1996) The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992. Int Urogynecol J Pelvic Floor Dysfunct 7:117–120CrossRefPubMed
15.
Zurück zum Zitat Farrell SA, Allen VM, Baskett TF (2001) Parturition and urinary incontinence in primiparas. Obstet Gynecol 97:350–356CrossRefPubMed Farrell SA, Allen VM, Baskett TF (2001) Parturition and urinary incontinence in primiparas. Obstet Gynecol 97:350–356CrossRefPubMed
16.
Zurück zum Zitat Mørkved S, Bø K (1999) Prevalence of urinary incontinence during pregnancy and postpartum. Int Urogynecol J Pelvic Floor Dysfunct 10:394–398CrossRefPubMed Mørkved S, Bø K (1999) Prevalence of urinary incontinence during pregnancy and postpartum. Int Urogynecol J Pelvic Floor Dysfunct 10:394–398CrossRefPubMed
17.
Zurück zum Zitat Spellacy E (2001) Urinary incontinence in pregnancy and the puerperium. J Obstet Gynecol Neonatal Nurs 30:634–641CrossRefPubMed Spellacy E (2001) Urinary incontinence in pregnancy and the puerperium. J Obstet Gynecol Neonatal Nurs 30:634–641CrossRefPubMed
18.
Zurück zum Zitat Iyoke CA, Ezugwu FO, Onal HE (2010) Prevalence and correlates of maternal morbidity in Enugu, South-East Nigeria. Afr J Reprod Health 14:121–129 Iyoke CA, Ezugwu FO, Onal HE (2010) Prevalence and correlates of maternal morbidity in Enugu, South-East Nigeria. Afr J Reprod Health 14:121–129
19.
Zurück zum Zitat Abrams P, Avery K, Gardener N, Donovan J, ICIQ Advisory Board (2006). The international consultation on incontinence questionnaire on urinary incontinence: www.iciq.net. J Urol1 75(3 Pt 1):1063–1066; discussion 1066 Abrams P, Avery K, Gardener N, Donovan J, ICIQ Advisory Board (2006). The international consultation on incontinence questionnaire on urinary incontinence: www.​iciq.​net. J Urol1 75(3 Pt 1):1063–1066; discussion 1066
20.
Zurück zum Zitat Boyles SH, Li H, Mori T, Osterweil P, Guise JM (2009) Effect of mode of delivery on the incidence of urinary incontinence in primiparous women. Obstet Gynecol 113:134–141CrossRefPubMed Boyles SH, Li H, Mori T, Osterweil P, Guise JM (2009) Effect of mode of delivery on the incidence of urinary incontinence in primiparous women. Obstet Gynecol 113:134–141CrossRefPubMed
21.
Zurück zum Zitat Olusanya O, Okpere EE, Ezimokhai M (1985) The importance of social class in voluntary fertility control in a developing country. West Afr J Med 4:205–212 Olusanya O, Okpere EE, Ezimokhai M (1985) The importance of social class in voluntary fertility control in a developing country. West Afr J Med 4:205–212
22.
Zurück zum Zitat Brincat C, Lewicky-Gaupp C, Patel D, Sampselle C, Miller J, Delancey JO, Fenner DE (2009) Fecal incontinence in pregnancy and postpartum. Int J Gynaecol Obstet 106:236–238PubMedCentralCrossRefPubMed Brincat C, Lewicky-Gaupp C, Patel D, Sampselle C, Miller J, Delancey JO, Fenner DE (2009) Fecal incontinence in pregnancy and postpartum. Int J Gynaecol Obstet 106:236–238PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Rubens BS, Tissot WD, Diokno AC (2006) Epidemiology: USA. In: Cardozo L, Staskin D (eds) Textbook of female urology and urogynaecology, vol 1, 2nd edn. Informa Healthcare Ltd, London, pp 13–22 Rubens BS, Tissot WD, Diokno AC (2006) Epidemiology: USA. In: Cardozo L, Staskin D (eds) Textbook of female urology and urogynaecology, vol 1, 2nd edn. Informa Healthcare Ltd, London, pp 13–22
24.
Zurück zum Zitat Fenner DE, Trowbridge ER, Patel DA, Fultz NH, Miller JM, Howard D, DeLancey JO (2008) Establishing the prevalence of incontinence study: racial differences in women’s patterns of urinary incontinence. J Urol 179:1455–1460PubMedCentralCrossRefPubMed Fenner DE, Trowbridge ER, Patel DA, Fultz NH, Miller JM, Howard D, DeLancey JO (2008) Establishing the prevalence of incontinence study: racial differences in women’s patterns of urinary incontinence. J Urol 179:1455–1460PubMedCentralCrossRefPubMed
25.
Zurück zum Zitat Hoyte L, Thomas J, Foster RT, Shott S, Jakab M, Weidner AC (2005) Racial differences in pelvic morphology among asymptomatic nulliparous women as seen on three-dimensional magnetic resonance images. Am J Obstet Gynecol 193:2035–2040CrossRefPubMed Hoyte L, Thomas J, Foster RT, Shott S, Jakab M, Weidner AC (2005) Racial differences in pelvic morphology among asymptomatic nulliparous women as seen on three-dimensional magnetic resonance images. Am J Obstet Gynecol 193:2035–2040CrossRefPubMed
26.
Zurück zum Zitat Howard D, Delancey JO, Tunn R, Ashton-Miller JA (2000) Racial differences in the structure and function of the stress urinary continence mechanism. Obstet Gynecol 95:713–717PubMedCentralCrossRefPubMed Howard D, Delancey JO, Tunn R, Ashton-Miller JA (2000) Racial differences in the structure and function of the stress urinary continence mechanism. Obstet Gynecol 95:713–717PubMedCentralCrossRefPubMed
27.
Zurück zum Zitat Solans-Domènech M, Sánchez E, Espuña-Pons M, Pelvic Floor Research Group (Grup de RecercadelSòlPelvià; GRESP) (2010) Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors. Obstet Gynecol 115:618–628CrossRefPubMed Solans-Domènech M, Sánchez E, Espuña-Pons M, Pelvic Floor Research Group (Grup de RecercadelSòlPelvià; GRESP) (2010) Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors. Obstet Gynecol 115:618–628CrossRefPubMed
28.
Zurück zum Zitat Ezegwui HU, Ikeakor LC, Egbuji C (2011) Fetal macrosomia: obstetric outcome of 311 cases in UNTH, Enugu, Nigeria. Niger J Clin Pract 14:332–336CrossRef Ezegwui HU, Ikeakor LC, Egbuji C (2011) Fetal macrosomia: obstetric outcome of 311 cases in UNTH, Enugu, Nigeria. Niger J Clin Pract 14:332–336CrossRef
29.
Zurück zum Zitat Baydock SA, Flood C, Schulz JA, MacDonald D, Esau D, Jones S, Hiltz CB (2009) Prevalence and risk factors for urinary and fecal incontinence 4 months after vaginal delivery. J Obstet Gynaecol Can 31:36–41PubMed Baydock SA, Flood C, Schulz JA, MacDonald D, Esau D, Jones S, Hiltz CB (2009) Prevalence and risk factors for urinary and fecal incontinence 4 months after vaginal delivery. J Obstet Gynaecol Can 31:36–41PubMed
30.
Zurück zum Zitat Sampselle CM (1990) Changes in pelvic muscle strength and stress urinary incontinence associated with childbirth. J Obstet Gynaecol Neonatal Nurs 19:371–377CrossRef Sampselle CM (1990) Changes in pelvic muscle strength and stress urinary incontinence associated with childbirth. J Obstet Gynaecol Neonatal Nurs 19:371–377CrossRef
Metadaten
Titel
Prevalence and predictors of urinary/anal incontinence after vaginal delivery: prospective study of Nigerian women
verfasst von
Kingsley Chukwu Obioha
Emmanuel Onyebuchi Ugwu
Samuel Nnamdi Obi
Cyril Chukwudi Dim
Theophilus Chimezie Oguanuo
Publikationsdatum
01.09.2015
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 9/2015
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-015-2690-0

Weitere Artikel der Ausgabe 9/2015

International Urogynecology Journal 9/2015 Zur Ausgabe

Urogynecology Digest

Urogynecology digest

Update Gynäkologie

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