[Changes in the position of the urethra and bladder neck during pregnancy and after delivery].
It is estimated that some 30-50% women suffer occasionally from urinary incontinence. At the end of pregnancy these complaints are more marked. In the author's group of 44 women 55% suffered from stress incontinence. The psychosocial impact of impaired function of the lower urinary pathways in women on different spheres of the patient's life is so serious that it calls for a qualified approach of a specialist. The increased mobility of the UV junction in incontinent women has been described by several authors [6, 12, 13]. It was also proved in the author's investigation closely before delivery and 3-5 days after delivery. Six weeks after delivery no differences were found in the mobility of the UV junction in continent and incontinent women. If the difference of the gamma angle (formed by the axis of the symphysis and the connecting line between the UV junction and the lower margin of the symphysis) during contraction of the muscles of the pelvic floor and Valsalva's manoeuvre (intraabdominal pressure raised by 30 cm H2O) is more than 30 degrees during the 40th week of gestation or 3-5 days after delivery (when this mobility is even greater), then the woman is liable to develop the stress type of incontinence and the authors recommend to use Kolpexin after the puerperium for exercise and strengthening of the muscles of the pelvic floor. Changes in the length of line p and angle beta are not statistically significant and cannot assess the disposition for development of urinary incontinence.
Martan
A
A
I. gynek.-porod. klinika 1. LF UK a VFN, Praha.
Drbohlav
P
P
Masata
M
M
Halaska
M
M
Voigt
R
R
D000328:Adult; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging*