Intervention for postpartum urinary incontinence

Intervention for postpartum urinary incontinence | Image Credit: © rocketclips - © rocketclips - stock.adobe.com.

According to a recent study published in Medicine, intervention is not necessary in patients with postpartum urinary incontinence.

Following childbirth, women often experience postpartum urinary incontinence, mainly presenting as involuntary leakage of urine associated with activities such as coughing, laughing, and exercising. Additional stress from childcare after delivery may exacerbate these effects, impacting quality of life and increasing the risk of future urinary incontinence.

Data on long-term urinary incontinence after delivery is lacking, indicating a need for further studies. Urinary incontinence has a reported 18% prevalence at 10 to 14 weeks post-delivery. Investigators conducted a study to identify risk factors associated with postpartum urinary incontinence in recently delivered nulliparous women during their first pregnancy.

Recruitment for the prospective cohort study occurred in Al-Ain Hospital, Al-Ain, United Arab Emirates from 2012 to 2014. Participants included consecutive nulliparous women with urinary incontinence for the first time during pregnancy. Follow-up lasted for 3 months after discharge.

Questionnaires were administered in both English and Arabic languages. Sections in the questionnaires included medical history, sociodemographic history, and pregnancy, childbirth, and 3 months postpartum characteristics. Interviewers underwent special training to improve their knowledge on the questionnaire and interviewing techniques.

Reported characteristics included smoking history, age, education level, and occupation, along with pregnancy characteristics including diabetes, urinary tract infections, chronic constipation, chronic chest problems, and smoking. Data was also gathered about pelvic floor muscles exercise and consultation by physiotherapy during pregnancy.

Pregnancy data collected also included labor type and duration of labor. Postpartum data collected included the child’s birth weight and urinary tract infection after delivery. Patients were placed into 1 of 2 groups based on postpartum urinary incontinence status at 3 months, with comparisons made using Fisher exact test and Mann-Whitney U test.

There were 101 nulliparous women with urinary incontinence during pregnancy included in the analysis, of which 77.2% were between 20 and 30 years old, 53.4% were housewives, 58.4% were highly educated, and 99% were nonsmokers. Urinary incontinence only in the postpartum period was seen in 13.8% of patients. Stress incontinence was seen in 93% of patients.

Statistical significance was not observed between any of the evaluated risk factors. This indicates most nulliparous women with postpartum urinary incontinence recover without the need for intervention. Investigators recommended expectant management rather than invasive intervention in patients with postpartum urinary incontinence.

Reference

Elbiss HM,Abu-Zidan FM. Postpartum urinary incontinence of nulliparous women: A prospective cohort study. Medicine. 2023;102(9). doi:10.1097/MD.0000000000033171