title: Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study.
abstract: OBJECTIVE
  There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them.
  
  
  METHODS
  Cross-sectional study, conducted in a public university.
  
  
  METHODS
  220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer.
  
  
  RESULTS
  The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m 2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence.
  
  
  CONCLUSIONS
  Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence.
authors: Laboratory of Experimental Research in Gynecology and Obstetrics, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista FMB-Unesp, Botucatu, São Paulo, Brazil. pasconbarbosa@uol.com.br
authors: Angélica Mércia Pascon
authors: AM
authors: Barbosa
authors: Gabriela
authors: G
authors: Marini
authors: Fernanda
authors: F
authors: Piculo
authors: Cibele Vieira Cunha
authors: CV
authors: Rudge
authors: Iracema Mattos Paranhos
authors: IM
authors: Calderon
authors: Marilza Vieira Cunha
authors: MV
authors: Rudge
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D009119:Muscle Contraction / Q000502:physiology*; D010298:Parity; D017773:Pelvic Floor / Q000503:physiopathology; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D015430:Weight Gain / Q000502:physiology*
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