Symptoms of anal and urinary incontinence following cesarean section or spontaneous vaginal delivery.
OBJECTIVE
The objective of the study was to compare the prevalence of incontinence disorders in relation with spontaneous vaginal delivery or cesarean section.


METHODS
Two hundred women with spontaneous vaginal deliveries only were compared with 195 women with cesarean deliveries only 10 years after first delivery.


RESULTS
When compared with cesarean section, vaginal delivery was associated with an increased frequency of stress urinary incontinence (P = .006) and an increased use of protective pads (P = .008) as well as an increased frequency of fecal urgency (P = .048) and gas incontinence (P = .01). At multivariate regression analysis, mode of delivery showed no significant association with incontinence symptoms other than an increased risk for flatus incontinence in women with a history of obstetric anal sphincter injury (odds ratio 3.1; 95% confidence interval, 1.5 to 8.9).


CONCLUSIONS
Incontinence symptoms are more common following spontaneous vaginal delivery when compared with cesarean section 10 years after first delivery. However, cesarean section is not associated with a major reduction of anal and urinary incontinence.
Altman
Daniel
D
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. daniel.altman@ki.se
Ekström
Asa
A
Forsgren
Catharina
C
Nordenstam
Johan
J
Zetterström
Jan
J
D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D010502:Perineum / Q000293:injuries; D011644:Puerperal Disorders / Q000453:epidemiology*; D012421:Rupture; D014549:Urinary Incontinence / Q000453:epidemiology*