Incontinencia urinaria a los 2 meses posparto. Persistencia de los síntomas a los 6 y 12 meses

Abstract

ObjectivesTo determine the prevalence of urinary incontinence (UI) 2 months after delivery as well as the factors associated with delivery and pregnancy. To determine the persistence of UI at 6 and 12 months after delivery among women with UI at 2 months after delivery. Material and methodsWe performed an observational, prospective, longitudinal study with follow-up at 2, 6 and 12 months after inclusion in the study during hospital admission for delivery in the Vic General Hospital, the basic general hospital in the region of Osona (central Catalonia). Women who delivered live newborns at term between 1 January, 2001 and 31 March, 2002 were included. During admission for delivery, data were gathered on 707 women (age, parity, body mass index, symptoms of incontinence during pregnancy), type of delivery (vaginal, cesarean) and fetuses (weight, head circumference). At 2 months after delivery, 531 women were seen by a gynecologists to detect and establish a clinical diagnosis of UI through a specific protocol.Women were asked whether they had involuntary leaks of urine. Women with UI symptoms underwent a pelvic examination and a pad test was requested. Women with UI at 2 months after delivery were called for further clinical evaluation at 6 months. All women with persistent symptoms at the 6-month visit were contacted by telephone at 12 months. The prevalence of UI at 2 months after delivery was calculated and the persistence of symptoms at 6 and 12 months of delivery was determined. The association of IU at 2 months of delivery with maternal, fetal, and delivery-related factors was analyzed by obtaining odds radios (OR) and confidence intervals. ResultsOf the 531 women seen 2 months after delivery, 41 were diagnosed with UI. At 12 months after delivery, 11 (26.8%) of the 41 women with UI had persistent symptoms. The prevalence of UI at 2 months after delivery was 7.7% (95% CI, 5.6- 10.3). A logistic regression model for UI at 2 months (dependent variable), in which the independent variables of type of delivery, maternal age, and weight and head circumference of the newborn were introduced, revealed that UI was associated with vaginal delivery (OR=14.4; 95% CI, 1.9-107.2). ConclusionsVaginal delivery is a known risk factor for UI and our results confirm the impact of this route of delivery in clinical practice in a general hospital. Although severe cases persist, there is substantial reduction in symptoms in the first 12 months.