Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: a cohort study.
OBJECTIVE
We estimated the incidence and remission of lower urinary tract symptoms during the 12 years following the first pregnancy and delivery.


METHODS
In a cohort study 242 primiparae were questioned about lower urinary tract symptoms 3 months, 5 years and 12 years after the first delivery.


RESULTS
From 3 months to 5 years after first delivery the incidence of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 56 of 213 cases (26.3%), 33 of 219 (15.1%), 33 of 206 (16.0%), 49 of 219 (22.4%) and 6 of 225 (2.7%), respectively. Remission of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 1 of 11 cases (9.1%), 2 of 5 (40%), 2 of 5 (40%), 4 of 7 (57.1%) and 1 of 1 (100%), respectively. From 5 to 12 years after the first delivery the incidence of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 40 of 158 cases (25.3%), 25 of 188 (13.3%), 24 of 175 (13.7%), 40 of 174 (23.0%) and 13 of 220 (5.9%), respectively. Remission of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 14 of 66 cases (21.2%), 13 of 36 (36.1%), 22 of 36 (61.1%), 14 of 52 (26.9%) and 4 of 6 (66.7%), respectively. Of 62 women with pure stress urinary incontinence during the first pregnancy and puerperium 20 (32.2%) had pure stress urinary incontinence, 3 (4.8%) had pure urge urinary incontinence and 15 (24.2%) had mixed urinary incontinence 12 years later. Of 13 women with pure urge urinary incontinence during the first pregnancy and puerperium 3 (23.1%) had pure urge urinary incontinence, 2 (15.4%) had pure stress urinary incontinence and 3 (23.1%) had mixed urinary incontinence 12 years later. The overall prevalence of lower urinary tract symptoms 12 years after the first delivery increased significantly.


CONCLUSIONS
The incidence and remission of lower urinary tract symptoms after the first pregnancy and delivery fluctuate and the types of urinary incontinence may interchange, while the overall prevalence of lower urinary tract symptoms increases in the long term.
Viktrup
Lars
L
Department of Obstetrics and Gynecology, Glostrup County Hospital, University of Copenhagen, Copenhagen, Denmark. viktrupla@lilly.com
Lose
Gunnar
G
D000328:Adult; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000503:physiopathology; D012075:Remission, Spontaneous; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology