Stress urinary incontinence six months after first vaginal delivery☆

Abstract 

Objective

To determine the prevalence, severity and impact on quality of life of stress urinary incontinence (SUI) six months after the first vaginal delivery, as well as to investigate the risk factors associated with it.

Study design

We designed a prospective study that included 396 women who had their first vaginal delivery in the Hospital Donostia. Diagnosis and identification of the type of urinary incontinence were carried out considering the 2002 ICS definitions. Women were interviewed and examined twice, at term and six months after delivery. The severity of the symptoms was evaluated with the Incontinence Severity Index (ISI) and the impact on quality of life was evaluated with the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form. The statistical analysis included comparison of means (Student's t-test or analysis of variance) and proportions (Chi square and Fisher's exact tests). Multiple logistic regression analysis was performed using variables that were close to statistical significance.

Results

15.1% of the women reported SUI six months after their first vaginal delivery. The ISI was slight or moderate in the majority of the cases and the impact on quality of life was low. The presence of SUI in pregnant women at term was the only independent risk factor associated with SUI after delivery (OR: 3.71; 95% IC: 1.95–7.06). The type of vaginal delivery did not influence in SUI six months after the birth, not even in women who were continent during pregnancy.

Conclusions

Slight or moderate SUI was common after the first vaginal delivery and the impact on quality of life was low. Urinary incontinence during pregnancy was the only risk factor independently associated with the presence of SUI six months after the first vaginal delivery.

Keywords: Primiparas, Stress urinary incontinence, Severity, Postpartum, Risk factors