Is anterior genital tract trauma associated with complaints of postpartum urinary incontinence?
We evaluated whether anterior genital trauma is associated with urinary incontinence after vaginal birth. A prospective cohort of midwifery patients consented to mapping of trauma at birth and assessment of continence postpartum. Trauma was categorized into intact, anterior (periuretheral, clitoral, labial), perineal or both. Incontinence was defined as a positive response to the question, “Since the birth of your baby, have you leaked urine when you did not mean to?” and social impact assessed by the Incontinence Impact Questionnaire-7 (IIQ-7). Of 554 eligible women, 436 (79%) provided incontinence data 3 months postpartum. Genital trauma was common, occurring in 80% of women: in 148 (34%) trauma was anterior, 119 (27%) had both anterior and perineal trauma and 80(18%) had only perineal trauma. Since delivery, 27% (118/436) women leaked urine. Fewer had IIQ-7 scores greater than 0, at 55/436 (12%). Women with anterior trauma, 29/148 (20%), were less likely to complain of incontinence than all others, 89/288 (31%) (P = 0.01). Urinary incontinence is common after giving birth, although most women have mild symptoms. Anterior trauma is not associated with increased complaints of urinary incontinence.
KeywordsUrinary incontinence Genital tract trauma
- 11.Gainey HL (1943) Post-partum observation of pelvic tissue damage. Am J Obstet Gynecol 45:457–466Google Scholar
- 13.Grand A (1989) The choice of suture materials and techniques for repair of perineal trauma: an overview of the evidence from controlled trials. Br J Obstet Gynaecol 96:1281–1289Google Scholar
- 15.Kettle C, Johanson RB (2000) Absorbable synthetic versus catgut suture material for perineal repair (Cochrane Review). In: The Cochrane Library, issue 4. Update Software, OxfordGoogle Scholar
- 17.Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA (1994) Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women (CPW) Research Group. Qual Life Res 3:291–306PubMedCrossRefGoogle Scholar
- 18.Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA (1995) Short forms to assess life quality and symptoms distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn 14:131–139PubMedCrossRefGoogle Scholar
- 19.Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE, Bump RC (1996) Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 175:1467–1470PubMedCrossRefGoogle Scholar