PD25-01 LONG-TERM IMPACT OF MODE OF DELIVERY ON STRESS URINARY INCONTINENCE AND URGENCY URINARY INCONTINENCE: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Value of Care: Cost and Outcomes Measures I1 Apr 2016PD25-01 LONG-TERM IMPACT OF MODE OF DELIVERY ON STRESS URINARY INCONTINENCE AND URGENCY URINARY INCONTINENCE: A SYSTEMATIC REVIEW AND META-ANALYSIS. Riikka Tähtinen, Rufus Cartwright, Johnson Tsui, Riikka Aaltonen, Yoshitaka Aoki, Jovita Cárdenas, Regina El Dib, Kirsi Joronen, Sumayyah Al Juaid, Sabreen Kalantan, Michal Kochana, Malgorzata Kopec, Luciane Lopes, Enaya Mirza, Sanna Oksjoki, Jori Pesonen, Antti Valpas, Li Wang, Yuqing Zhang, Diane Heels-Ansdell, Gordon Guyatt, and Kari Tikkinen Riikka TähtinenRiikka Tähtinen More articles by this author , Rufus CartwrightRufus Cartwright More articles by this author , Johnson TsuiJohnson Tsui More articles by this author , Riikka AaltonenRiikka Aaltonen More articles by this author , Yoshitaka AokiYoshitaka Aoki More articles by this author , Jovita CárdenasJovita Cárdenas More articles by this author , Regina El DibRegina El Dib More articles by this author , Kirsi JoronenKirsi Joronen More articles by this author , Sumayyah Al JuaidSumayyah Al Juaid More articles by this author , Sabreen KalantanSabreen Kalantan More articles by this author , Michal KochanaMichal Kochana More articles by this author , Malgorzata KopecMalgorzata Kopec More articles by this author , Luciane LopesLuciane Lopes More articles by this author , Enaya MirzaEnaya Mirza More articles by this author , Sanna OksjokiSanna Oksjoki More articles by this author , Jori PesonenJori Pesonen More articles by this author , Antti ValpasAntti Valpas More articles by this author , Li WangLi Wang More articles by this author , Yuqing ZhangYuqing Zhang More articles by this author , Diane Heels-AnsdellDiane Heels-Ansdell More articles by this author , Gordon GuyattGordon Guyatt More articles by this author , and Kari TikkinenKari Tikkinen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.231AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) are associated with physical and psychological morbidity, and large social costs. The long-term effects of delivery modes on each kind of incontinence remain uncertain. We performed a systematic review and meta-analysis to investigate the long-term impact of mode of delivery on SUI and UUI. METHODS We searched MEDLINE, Scopus, and CINAHL, and abstracts from relevant major conferences, up to October 2014. Any randomized trial or observational study with adjusted analyses, comparing estimates for the impact of two delivery modes on the risk of SUI or UUI more than 1-year post delivery were eligible. Two reviewers extracted data, including incidence/prevalence of SUI and UUI by delivery modes, and assessed risk of bias. Outcomes were categorized in accordance with ICS/IUGA definitions, and we followed PRISMA reporting guidance. RESULTS Our search yielded 3,487 potentially relevant reports of which 16 studies for SUI, and 8 studies for UUI proved eligible. Pooled estimates from 15 eligible studies demonstrated an increased risk of SUI after vaginal delivery versus cesarean section (adjusted odds ratio, aOR; 1.85, 95%CI 1.56-2.19; I2=57%), risk difference 8.2% (Fig 1). A meta-regression demonstrated a stronger association with vaginal delivery in younger women (P=0.005). Four studies suggested no difference in the risk of SUI between spontaneous vaginal and instrumental delivery (aOR 1.11, 95%CI 0.84-1.45; I2=50%). Eight studies suggested an elevated risk of UUI after vaginal delivery versus cesarean section (aOR 1.30 95%CI 1.02-1.65; I2=37%), risk difference 2.6%. Figure 1. Forest plot, risk of stress urinary incontinence between vaginal delivery and cesarean section CONCLUSIONS Vaginal delivery is associated with an almost twofold increase in the risk of long-term SUI, an absolute increase of 8%, when compared to cesarean section. The gradient of risk is larger in younger and smaller in older women. There is also an increased risk of UUI, with an absolute increase of approximately 3%. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e587 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Riikka Tähtinen More articles by this author Rufus Cartwright More articles by this author Johnson Tsui More articles by this author Riikka Aaltonen More articles by this author Yoshitaka Aoki More articles by this author Jovita Cárdenas More articles by this author Regina El Dib More articles by this author Kirsi Joronen More articles by this author Sumayyah Al Juaid More articles by this author Sabreen Kalantan More articles by this author Michal Kochana More articles by this author Malgorzata Kopec More articles by this author Luciane Lopes More articles by this author Enaya Mirza More articles by this author Sanna Oksjoki More articles by this author Jori Pesonen More articles by this author Antti Valpas More articles by this author Li Wang More articles by this author Yuqing Zhang More articles by this author Diane Heels-Ansdell More articles by this author Gordon Guyatt More articles by this author Kari Tikkinen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...