title: Parity and route of delivery: does cesarean delivery reduce bladder symptoms later in life?
abstract: OBJECTIVE
  This study was undertaken to investigate the impact of reproductive factors on the prevalence of urinary symptoms.
  
  
  METHODS
  Participants were women scheduled for hysterectomy (n=1299). Before surgery, urinary symptoms were assessed by questionnaire. Multiple logistic regression analysis was used to investigate the association between bladder symptoms and parity, route of delivery, and other characteristics.
  
  
  RESULTS
  Stress incontinence and urinary urgency were more prevalent among parous than nulliparous women (P <.01). Controlling for parity and other characteristics, women who had a history of cesarean delivery were significantly less likely to report stress incontinence than women with a history of vaginal delivery (odds ratio 0.60; 95% CI 0.39-0.93).
  
  
  CONCLUSIONS
  Women who have undergone vaginal delivery are more likely to report stress incontinence than women who have delivered by cesarean section. Although this suggests that cesarean delivery might reduce incontinence later in life, further research is needed to clarify the long-term risks, benefits, and costs of cesarean delivery.
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Handa
authors.forename: Lynn
authors.initials: L
authors.lastname: Harvey
authors.forename: Harold E
authors.initials: HE
authors.lastname: Fox
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Kjerulff
mesh_terms: D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D016015:Logistic Models; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014550:Urinary Incontinence, Stress / Q000453:epidemiology; D014555:Urination Disorders / Q000453:epidemiology*; D014596:Uterine Prolapse / Q000453:epidemiology