Stress incontinence during pregnancy and in puerperium

Abstract

A retrospective follow-up investigation dealing with the frequency of stress incontinence was carried out among maternities at the Women's Clinic in Lund over a period of 15 months. Of 1500 newly-delivered women whose interviews were solicited, 1411 responded. Twenty-two percent indicated symptoms of stress incontinence. These were examined gynecologically, including Bonney's test. The material may be divided into four groups according to the onset and type of stress incontinence: — Onset of stress incontinence prior to pregnancy in connection with puberty; 8.5% of the total number of stress incontinents (2% of the entire material). — Permanent stress incontinence with onset during pregnancy; 23% of all stress incontinents (5% of the entire material). — Temporary, mild, “physiological” stress incontinence, manifest only during the second part of the pregnancy and disappearing approximately 3 months after delivery. This type of incontinence represents 50% of all stress incontinents (11% of the entire material). — Stress incontinence arising in conjunction with or following parturition; 19% of all cases of stress incontinence (4% of the entire material). Of the patients in this group 8% were temporarily incontinent. Eleven percent (2.3% of the entire material), represents women suffering from constant incontinence which first appeared in connection with childbirth. It is more often the case that stress incontinence begins during the first pregnancy rather than during subsequent pregnancies (statistical significance P ⩽ 0.05). The results indicate that the pregnancy itself and hereditary factors predispose more readily than the parturition trauma to the occurrence of stress incontinence.