Longitudinal comparison study of pelvic floor function between women with and without stress urinary incontinence after vaginal delivery.
OBJECTIVE
To compare the pelvic floor function between women with and without stress urinary incontinence after vaginal delivery.


METHODS
Seventeen women (age 35.5 ± 3.5) were prospectively studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire - Short Form. Pelvic floor function was assessed by antero-posterior diameter of the levator hiatus using transperineal ultrasound.


RESULTS
Five of 17 women experienced postpartum stress urinary incontinence. The antero-posterior diameter of the levator hiatus at rest was significantly longer in stress urinary incontinent women than in continent women until 3 months after delivery (p < 0.01), though shortening of the antero-posterior diameter of the levator hiatus was not significantly different between continent women and stress urinary incontinent women. Regardless of urinary incontinence, the antero-posterior diameter of the levator hiatus at rest shortened at 6 months postpartum, compared to 6 weeks postpartum (p < 0.001). The antero-posterior diameter of the levator hiatus during contraction had shortened only in continent women by 6 months postpartum (p = 0.02).


CONCLUSIONS
The extended pelvic floor may be a cause of stress urinary incontinence in the postpartum period. Therefore, treatment to improve the extended pelvic floor should be developed for the prevention of stress urinary incontinence.
Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan. mokka-tky@umin.ac.jp.
Mikako
M
Yoshida
Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan.
Ryoko
R
Murayama
Department of Midwifery and Women's Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Megumi
M
Haruna
Department of Midwifery and Women's Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Masayo
M
Matsuzaki
Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan.
Kenichi
K
Yoshimura
Oita University of Nursing and Health Science, Oita, Japan.
Sachiyo
S
Murashima
Department of OB/GYN, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Shiro
S
Kozuma
Pelvic floor function; Postpartum; Stress urinary incontinence; Transperineal ultrasound