title: Female urinary incontinence, from pregnancy to menopause: a review of epidemiological and pathophysiological findings.
abstract: Hypotheses that might explain urinary incontinence during pregnancy and after childbirth have been examined. The prevalence of urinary incontinence reaches a maximum during pregnancy and decreases after childbirth. Cesarean delivery is associated with lower rates of stress incontinence than vaginal delivery. Women delivered by cesarean section differ from women who had a vaginal delivery through pre-existing characteristics associated with the incontinence risk, producing a selection bias. The only randomized trial (intention of vaginal delivery vs. elective caesarean section) was not conclusive. The suspected etiological factors consist of congenital elements, obesity, aging, pregnancy and vaginal delivery. They are likely to have an effect at different times and on different portions of the urethral sphincter complex. Unfortunately, there exist no cohorts facilitating description of the natural history of female urinary incontinence. Given the small amount of usable data available, it is not possible to draw any conclusions concerning the possible long-term protective effects of cesarean section.
authors.affiliation: Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, INSERM, UMR S953, UPMC University of Paris 6, Villejuif, France. xavier.fritel@univ-poitiers.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
authors.forename: Virginie
authors.initials: V
authors.lastname: Ringa
authors.forename: Emeline
authors.initials: E
authors.lastname: Quiboeuf
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fauconnier
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008593:Menopause; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010298:Parity; D036801:Parturition; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D012075:Remission, Spontaneous; D012307:Risk Factors; D015983:Selection Bias; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D053202:Urinary Incontinence, Urge / Q000453:epidemiology / Q000209:etiology