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Diagnostic d’une incontinence urinaire en cours de grossesse et dans le post-partum : revue de la littérature

Diagnosis of urinary incontinence during pregnancy and post partum: a comprehensive review of literature

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Pelvi-périnéologie

Résumé

L’objectif de ce travail était de faire une revue de la littérature de la problématique du diagnostic de l’incontinence urinaire (IU) au cours de la grossesse et dans le post-partum. La prévalence des symptômes d’IU augmente au cours de la grossesse (entre le premier et le troisième trimestre), puis diminue spontanément dans les trois premiers mois du post-partum. La valeur de l’interrogatoire, de l’examen clinique (stress test, Q-TIP test, pad-test), de l’échographie et de l’urodynamique (débitmétrie, cystomanométrie, profilométrie) dans le diagnostic d’IU au cours de la grossesse et dans le post-partum ont été étudiées. Les résultats du test à la toux et du pad-test en cours de grossesse ne semblent pas correctement corrélés aux symptômes d’incontinence urinaire à l’effort (IUE) rapportés par les patientes. La réalisation de ces examens en cours de grossesse n’est pas recommandée. Même s’il ne semble pas y avoir de complication fréquente consécutive à la réalisation d’une cystomanométrie et d’une profilométrie en cours de grossesse, il n’y pas d’argument dans la littérature pour recommander leur réalisation devant une IU en cours de grossesse.

Abstract

The goal of the current study was to systematically review the literature concerning the diagnosis of urinary incontinence during pregnancy and post partum. The prevalence of urinary stress incontinence and overactive bladder symptoms increase with gestational age during pregnancy (from the first to the third trimester) and decrease during the third months following delivery. The value of medical history, physical examination (stress test, Q-TIP test, and pad test), ultrasonography, and urodynamics (uroflowmetry, cystometry, and profilometry) in diagnosing urinary incontinence during pregnancy and following delivery have been assessed. There is no correlation between cough stress test, pad test, and symptoms of urinary incontinence reported by women during pregnancy. Thus, it is not recommended to perform cough stress test and pad test during pregnancy. Very few complications have been reported following urodynamics during pregnancy. However, no data support their use during pregnancy.

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Authors and Affiliations

  1. Service de gynécologie obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, F-92141, Clamart, France

    T. Thubert, E. Faivre, C. Trichot, A.-C. Donnadieu, A. Benachi & X. Deffieux

  2. faculté de médecine Paris-Sud, Université Paris-Sud, F-94275, Le Kremlin-Bicêtre, France

    A.-C. Donnadieu, A. Benachi & X. Deffieux

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  1. T. Thubert
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  2. E. Faivre
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  3. C. Trichot
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  4. A.-C. Donnadieu
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  5. A. Benachi
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  6. X. Deffieux
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Correspondence to X. Deffieux.

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Thubert, T., Faivre, E., Trichot, C. et al. Diagnostic d’une incontinence urinaire en cours de grossesse et dans le post-partum : revue de la littérature. Pelv Perineol 5, 90–96 (2010). https://doi.org/10.1007/s11608-010-0296-z

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  • DOI: https://doi.org/10.1007/s11608-010-0296-z

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