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Erschienen in: International Urogynecology Journal 2/2008

01.02.2008 | Original Article

Urinary incontinence after obstetric anal sphincter injuries (OASIS)—is there a relationship?

verfasst von: Inka Scheer, Vasanth Andrews, Ranee Thakar, Abdul H. Sultan

Erschienen in: International Urogynecology Journal | Ausgabe 2/2008

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Abstract

This study aimed to compare urinary symptoms and its impact on women’s quality of life after obstetric anal sphincter injuries (OASIS) with a matched control group in the short term. The study group consisted of 100 primiparous women with OASIS and 104 controls who sustained a second-degree tear or had a mediolateral episiotomy performed. All women completed a validated International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire 10 weeks after delivery. Compared to controls, significantly more women with OASIS reported overall urinary incontinence (21.2 vs 38%, p = 0.005) and had significantly worse quality of life score (incontinence score: 2.42 vs 1.2; p = 0.008). Significantly more women with OASIS suffered from stress urinary incontinence (33 vs 14%; p = 0.002; OR 3.06; CI = 1.54–6.07) than controls. Logistic regression analysis revealed that OASIS and a prolonged (>50 min) second stage of labour were independent risk factors for the development of stress urinary incontinence. This study highlights the importance of inquiring about urinary incontinence in women with OASIS.
Literatur
1.
Zurück zum Zitat Harrison GL, Memel DS (1994) Urinary incontinence in women: its prevalence and its management in a health promotion clinic. Br J Gen Pract 44(381):149–152PubMed Harrison GL, Memel DS (1994) Urinary incontinence in women: its prevalence and its management in a health promotion clinic. Br J Gen Pract 44(381):149–152PubMed
2.
Zurück zum Zitat Chaliha C, Kalia V, Stanton SL et al (1999) Antenatal Prediction of postpartum urinary and fecal incontinence. Obstet Gynecol 94(5 Pt 1):689–693PubMedCrossRef Chaliha C, Kalia V, Stanton SL et al (1999) Antenatal Prediction of postpartum urinary and fecal incontinence. Obstet Gynecol 94(5 Pt 1):689–693PubMedCrossRef
3.
Zurück zum Zitat Viktrup L, Lose G, Rolff M et al (1992) The symptom of stress incontinence caused by pregnancy or delivery in primiparas. Obstet Gynecol 79:945–949PubMed Viktrup L, Lose G, Rolff M et al (1992) The symptom of stress incontinence caused by pregnancy or delivery in primiparas. Obstet Gynecol 79:945–949PubMed
4.
Zurück zum Zitat Wilson PD, Herbison RM, Herbison GP (1996) Obstetric practice and the prevalence of urinary incontinence three months after delivery. BJOG 103:154–161CrossRef Wilson PD, Herbison RM, Herbison GP (1996) Obstetric practice and the prevalence of urinary incontinence three months after delivery. BJOG 103:154–161CrossRef
5.
Zurück zum Zitat Snooks SJ, Swash M, Setchell M et al (1984) Injury to the innervation of pelvic floor sphincter musculature in childbirth. Lancet 2:546–550PubMedCrossRef Snooks SJ, Swash M, Setchell M et al (1984) Injury to the innervation of pelvic floor sphincter musculature in childbirth. Lancet 2:546–550PubMedCrossRef
6.
Zurück zum Zitat Snooks SJ, Badenoch DF, Tiptaft RC et al (1985) Perineal nerve damage in genuine stress incontinence. An electrophysiological study. . Br J Urol 57:422–426PubMedCrossRef Snooks SJ, Badenoch DF, Tiptaft RC et al (1985) Perineal nerve damage in genuine stress incontinence. An electrophysiological study. . Br J Urol 57:422–426PubMedCrossRef
7.
Zurück zum Zitat Allen RE, Hosker GL, Smith ARB et al (1990) Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol 97:770–779PubMed Allen RE, Hosker GL, Smith ARB et al (1990) Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol 97:770–779PubMed
8.
Zurück zum Zitat Sampselle CM (1990) Changes in pelvic floor strength associated with childbirth. J Obstet Gynecol Neonatal Nurs 19:371–377PubMedCrossRef Sampselle CM (1990) Changes in pelvic floor strength associated with childbirth. J Obstet Gynecol Neonatal Nurs 19:371–377PubMedCrossRef
9.
Zurück zum Zitat Sultan AH, Kamm MA, Hudson CN (1994) Pudendal nerve damage during labour: prospective study before and after childbirth. BJOG 101:22–28CrossRef Sultan AH, Kamm MA, Hudson CN (1994) Pudendal nerve damage during labour: prospective study before and after childbirth. BJOG 101:22–28CrossRef
10.
Zurück zum Zitat Peschers UM, Schaer G, Anthuber C et al (1996) Changes in vesical neck mobility following vaginal delivery. Obstet Gynecol 88:1001–1006PubMedCrossRef Peschers UM, Schaer G, Anthuber C et al (1996) Changes in vesical neck mobility following vaginal delivery. Obstet Gynecol 88:1001–1006PubMedCrossRef
11.
Zurück zum Zitat King JK, Freeman RM (1998) Is antenatal bladder neck mobility a risk factor for postpartum stress incontinence. BJOG 105:1300–1307CrossRef King JK, Freeman RM (1998) Is antenatal bladder neck mobility a risk factor for postpartum stress incontinence. BJOG 105:1300–1307CrossRef
12.
Zurück zum Zitat Fenner D, Genberg B, Brahma P et al (2003) Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol 189(6):1543–1549PubMedCrossRef Fenner D, Genberg B, Brahma P et al (2003) Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol 189(6):1543–1549PubMedCrossRef
13.
Zurück zum Zitat Sultan AH, Kamm MA, Hudson CN et al (1993) Anal sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911PubMedCrossRef Sultan AH, Kamm MA, Hudson CN et al (1993) Anal sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911PubMedCrossRef
14.
Zurück zum Zitat Zetterstrom JP, López A, Anzén B et al (1999) Anal incontinence after vaginal delivery: a prospective study in primiparous women. BJOG 106:324–330CrossRef Zetterstrom JP, López A, Anzén B et al (1999) Anal incontinence after vaginal delivery: a prospective study in primiparous women. BJOG 106:324–330CrossRef
15.
Zurück zum Zitat Wagenius J, Laurin J (2003) Clinical symptoms after anal sphincter rupture: a retrospective study. Acta Obstet Gynecol Scand 82:246–250PubMedCrossRef Wagenius J, Laurin J (2003) Clinical symptoms after anal sphincter rupture: a retrospective study. Acta Obstet Gynecol Scand 82:246–250PubMedCrossRef
16.
Zurück zum Zitat Nazir M, Stien R, Carlsen E et al (2003) Early evaluation of bowel symptoms after primary repair of obstetric perineal rupture misleading. Dis Colon Rectum 46(9):1245–1250PubMedCrossRef Nazir M, Stien R, Carlsen E et al (2003) Early evaluation of bowel symptoms after primary repair of obstetric perineal rupture misleading. Dis Colon Rectum 46(9):1245–1250PubMedCrossRef
17.
Zurück zum Zitat Tetzschner T, Sørensen M, Lose G et al (1996) Anal and urinary incontinence in women with obstetric anal sphincter rupture. BJOG 103:1034–1040CrossRef Tetzschner T, Sørensen M, Lose G et al (1996) Anal and urinary incontinence in women with obstetric anal sphincter rupture. BJOG 103:1034–1040CrossRef
18.
Zurück zum Zitat Ustal Fornell E, Wingeren G, Kjølhede P (2004) Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study. Acta Obstet Gynecol Scand 83:383–389CrossRef Ustal Fornell E, Wingeren G, Kjølhede P (2004) Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study. Acta Obstet Gynecol Scand 83:383–389CrossRef
19.
Zurück zum Zitat Otero M, Boulvain M, Bianchi-Demicheli F et al (2006) Women’s health 18 years after rupture of the anal sphincter during childbirth. II Urinary incontinence, sexual function, and physical and mental health. Am J Obstet Gynecol 194(5):1260–1265PubMedCrossRef Otero M, Boulvain M, Bianchi-Demicheli F et al (2006) Women’s health 18 years after rupture of the anal sphincter during childbirth. II Urinary incontinence, sexual function, and physical and mental health. Am J Obstet Gynecol 194(5):1260–1265PubMedCrossRef
20.
Zurück zum Zitat Glazener CMA, Herbison GP, MacAthur C et al (2006) New postnatal urinary incontinence: obstetric and other risk factors in primiparae. BJOG 113:208–217PubMedCrossRef Glazener CMA, Herbison GP, MacAthur C et al (2006) New postnatal urinary incontinence: obstetric and other risk factors in primiparae. BJOG 113:208–217PubMedCrossRef
21.
Zurück zum Zitat Foldsprang A, Hvidman L, Mommsen S et al (2004) Risk of postpartum urinary incontinence associated with pregnancy and mode of delivery. Acta Obstet Scand 83:923–297CrossRef Foldsprang A, Hvidman L, Mommsen S et al (2004) Risk of postpartum urinary incontinence associated with pregnancy and mode of delivery. Acta Obstet Scand 83:923–297CrossRef
22.
Zurück zum Zitat Farrell S, Allen VM, Baskett TF (2001) Parturition and urinary incontinence in primiparas. Obstet Gynecol 97(3):350–356PubMedCrossRef Farrell S, Allen VM, Baskett TF (2001) Parturition and urinary incontinence in primiparas. Obstet Gynecol 97(3):350–356PubMedCrossRef
23.
Zurück zum Zitat Avery K, Donovan JL, Abrams P (2001) Validation of a new questionnaire for incontinence: the international consultation on incontinence questionnaire (ICI-Q). Neurourol Urodyn 20:86 Avery K, Donovan JL, Abrams P (2001) Validation of a new questionnaire for incontinence: the international consultation on incontinence questionnaire (ICI-Q). Neurourol Urodyn 20:86
24.
Zurück zum Zitat Donovan JL, Badia X ,Corcos J (2002) Symptoms and quality of life assessment. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, 2nd edn. Health Publication Bristol,pp 269–316 Donovan JL, Badia X ,Corcos J (2002) Symptoms and quality of life assessment. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, 2nd edn. Health Publication Bristol,pp 269–316
25.
Zurück zum Zitat Andrews V, Sultan AH, Thakar R et al (2006) Occult anal sphincter injuries—myth or reality. BJOG 113(2):195–200PubMedCrossRef Andrews V, Sultan AH, Thakar R et al (2006) Occult anal sphincter injuries—myth or reality. BJOG 113(2):195–200PubMedCrossRef
26.
Zurück zum Zitat Adams EJ, Fernando RJ (2001) Management of third and fourth degree tears following vaginal deliveries. Royal College of Obstetricians and Gynaecologists 2001; Guideline No. 29 Adams EJ, Fernando RJ (2001) Management of third and fourth degree tears following vaginal deliveries. Royal College of Obstetricians and Gynaecologists 2001; Guideline No. 29
27.
Zurück zum Zitat Borello-France D, Burgio KL, Richter HE et al (2006) Fecal and urinary incontinence in primiparous women. Obstet Gynecol 108(4):863–872PubMedCrossRef Borello-France D, Burgio KL, Richter HE et al (2006) Fecal and urinary incontinence in primiparous women. Obstet Gynecol 108(4):863–872PubMedCrossRef
28.
Zurück zum Zitat Fritsch H, Mitterberger M, Barbel G et al (2006) What are the supportive structures of the female urethra. Neurourol Urodyn 25(2):128–134PubMedCrossRef Fritsch H, Mitterberger M, Barbel G et al (2006) What are the supportive structures of the female urethra. Neurourol Urodyn 25(2):128–134PubMedCrossRef
29.
Zurück zum Zitat Dietz HP, Lanzarone V (2005) Levator trauma after vaginal delivery. Obstet Gynecol 106(4):707–712PubMed Dietz HP, Lanzarone V (2005) Levator trauma after vaginal delivery. Obstet Gynecol 106(4):707–712PubMed
30.
Zurück zum Zitat Dolan LM, Hosker GL, Mallett VT et al (2003) Stress incontinence and pelvic floor neurophysiology 15 years after first delivery. BJOG 110:1107–1114PubMedCrossRef Dolan LM, Hosker GL, Mallett VT et al (2003) Stress incontinence and pelvic floor neurophysiology 15 years after first delivery. BJOG 110:1107–1114PubMedCrossRef
Metadaten
Titel
Urinary incontinence after obstetric anal sphincter injuries (OASIS)—is there a relationship?
verfasst von
Inka Scheer
Vasanth Andrews
Ranee Thakar
Abdul H. Sultan
Publikationsdatum
01.02.2008
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 2/2008
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-007-0431-8

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