Factors Of Stress Urinary Incontinence Research Articles

Predicting stress urinary incontinence during pregnancy: combination of pelvic floor ultrasound parameters and clinical factors.

The aim of this study was to develop and validate a predictive tool that combines pelvic floor ultrasound parameters and clinical factors for stress urinary incontinence during pregnancy. A total of 535 women in the first or second trimester of pregnancy were included for an interview and transperineal ultrasound assessment from two hospitals. Imaging data sets were analyzed offline to assess for bladder neck vertical position, urethra angles (α, β and γ angles), hiatal area and bladder neck funneling. All significant continuous variables at univariable analysis were analyzed by receiver operating characteristics. Three multivariable logistic models were built on clinical factors, and combined with ultrasound parameters. The final predictive model with best performance and fewest variables was selected to establish a nomogram. Internal and external validation of the nomogram was performed by both discrimination represented by C-index and calibration measured by Hosmer-Lemeshow test. A decision curve analysis was conducted to determine the clinical utility of the nomogram. After excluding 14 women with invalid data, 521 women were analyzed. β angle, γ angle and hiatal area had limited predictive value for stress urinary incontinence during pregnancy, with area under curves of 0.558-0.648. The final predictive model included body mass index gain since pregnancy, constipation, previous delivery mode, β angle at rest, and bladder neck funneling. The nomogram based on the final model showed good discrimination with a C-index of 0.789 and satisfactory calibration (p=0.828), both of which were supported by external validation. Decision curve analysis showed that the nomogram was clinically useful. The nomogram incorporating both the pelvic floor ultrasound parameters and clinical factors has been validated to show good discrimination and calibration, and could be an important tool for stress urinary incontinence risk prediction at an early stage of pregnancy.

Persistent stress urinary incontinence during pregnancy and one year after delivery; its prevalence, risk factors and impact on quality of life in Taiwanese women: An observational cohort study

ObjectiveThe study was to investigate the prevalence and risk factors of stress urinary incontinence (SUI) and its impact on the quality of life during pregnancy and 12 months after delivery. Materials and methods866 women delivering their newborns at a tertiary hospital were recruited. All women were asked to complete several questionnaires including demographic and obstetric data, Short Form 12 health survey (SF-12), Urogenital Distress Inventory Short Form (UDI-6), and Incontinence Impact Questionnaire Short Form (IIQ-7). All women were interviewed via telephone to answer the same questionnaires at 12 months postpartum. ResultsThere were 446 (51.5%) self-reported SUI women during pregnancy. Out of 560 women delivered vaginally, 70 (12.5%) had SUI at 12 months postpartum; in 306 women undergoing Cesarean delivery, 22 (7.2%) experienced SUI 12 months after delivery. Risk factors of SUI during pregnancy included body weight and body mass index at first visit. At 12 months postpartum, parity stood out as the risk factor of persistent SUI in vaginal delivery group, but no significant risk factor was found in Cesarean group. Women with SUI during pregnancy featured worse mental component summary (MCS) score of SF-12, compared to women without SUI. At 12 months postpartum, women with persistent SUI in vaginal delivery group had higher mean UDI-6 and IIQ-7 scores than those without SUI. ConclusionPersistent SUI is more prevalent in the vaginal delivery group than Cesarean group. Both SUI during pregnancy and after childbirth have negative impact on the quality of life in women undergoing vaginal delivery.

Risk factors for stress urinary incontinence after native-tissue vaginal repair of pelvic organ prolapse.

To identify risk factors for postoperative stress urinary incontinence (POSUI) after native-tissue prolapse repair without a concomitant anti-incontinence procedure. The present single-center retrospective study included women with genital prolapse who underwent high uterosacral ligament suspension without a concomitant anti-incontinence procedure during 2008-2013. Univariate and multivariate analyses were performed to identify risk factors for POSUI (identified through clinical interview and International Consultation on Incontinence Modular Questionnaire-Short Form [ICIQ-SF] self-administration) at 6months. In total, 87 (20.9%) of 417 women developed POSUI. Preoperative stress urinary incontinence (SUI) and urodynamically diagnosed SUI were significantly associated with POSUI; moreover, women with POSUI had a higher preoperative ICIQ-SF score, a lower opening detrusor pressure, and a lower detrusor pressure at maximum flow than did women without POSUI (P<0.05 for all comparisons). In the multivariate analysis, preoperative SUI (odds ratio 3.11), a detrusor pressure at maximum flow of less than 30cm H2 O (odds ratio 2.93), and urodynamically diagnosed SUI (odds ratio 2.26) were independent risk factors for POSUI. Preoperative urodynamic parameters, obtained before prolapse repair surgery, were associated with POSUI and could be useful in providing adequate counseling to facilitate decision making on whether to add a concomitant anti-incontinence procedure.

The Prevalence and Risk Factors of Stress Urinary Incontinence in Postpartum

Objective: To know the incidence of stress urinary incontinence in&#x0D; postpartum and determine the relationship among age, parity, infant&#x0D; birth weight, mode of delivery, episiotomy and perineum rupture.&#x0D; &#x0D; Method: This study used cross sectional analytic design. Qualified&#x0D; subjects from inclusion criteria were interviewed by researchers&#x0D; using pre-defined MESA questioner. Subjects with stress urinary&#x0D; incontinence were found from the questionnaire result. The acquired&#x0D; data was measured and analyzed using SPSS v. 22.0 software and&#x0D; discussed using available literature.&#x0D; &#x0D; Result: From 162 subjects, 36 cases (22.22%) had stress urinary&#x0D; incontinence, 47.22% aging ? 35 years old, 72.22% had multiple&#x0D; pregnancies, 88.89% had per vaginal delivery. Using multivariate&#x0D; logistic regression test, we found there was a relationship between&#x0D; stress urinary incontinence with age and parity (p 35 years old and multiple parities.&#x0D; &#x0D; Keywords: multiple parities, post-partum, stress urinary incontinence

Stress Urinary Incontinence in Women With Multiple Sclerosis.

PurposeTo report the prevalence and risk factors of stress urinary incontinence (SUI) and the prevalence of intrinsic sphincter deficiency in women with multiple sclerosis (MS).MethodsWe conducted a retrospective study. Female patients with MS, followed for lower urinary tract symptoms (LUTS) during a 15-year period were included. Demographic data, MS history, expanded disability status scale (EDSS) score at the urodynamic visit, obstetrical past, birth weight, LUTS, and urodynamic findings were collected. SUI was defined as incontinence during cough, or any effort. A maximum urethral closure pressure less than 30 cm H2O defined intrinsic sphincter deficiency.ResultsWe included 363 women with a mean age of 46.7±10.8 years and a mean disease duration of 12.9±8.7 years. The incidence of relapsing remitting MS, a secondary progressive form, and a primary progressive form was 60.6%, 32.8%, and 6.6%, respectively. The prevalence of SUI was 31.4%. The prevalence of intrinsic sphincter deficiency was 1.4% and 0.8% of these patients had a SUI (P=0.300). In a multivariate analysis, women with a SUI had significantly higher birth weight (P=0.030), a pelvic organ prolapse (P=0.021), urgent urinary incontinence (P=0.006), a lower EDSS score (P=0.019), and a weaker containing effort (P<0.001).ConclusionsThe prevalence of SUI in women with MS was 31.4%. This symptom could affect the quality of life of women with MS.

Prevalence of stress urinary incontinence in elite female endurance athletes.

The goal of the study was to assess the prevalence of stress urinary incontinence in a group of elite female endurance athletes, as professional sport is one of the risk factors for stress urinary incontinence. SUI rates in the groups of female cross-country skiers and runners were compared to determine whether the training weather conditions like temperature and humidity influenced the prevalence of urinary incontinence. An anonymous questionnaire was distributed among 112 elite female athletes ie., 57 cross-country skiers and 55 runners. We used a short form of the Urogenital Distress Inventory (UDI-6) to assess the presence of SUI symptoms and the level of urogenital distress. Only women who had been practicing sport professionally for at least 3 years, on an international and national level, were included in the research. The study group consisted of 76% nulliparous and 24% parous women. 45.54% of all participants reported leakage of urine associated with sneezing or coughing which indicates stress urinary incontinence. 29.46% were not bothered by the urogenital distress symptoms. 42.86% of the participants were slightly bothered by the symptoms, 18.75% were moderately bothered, 8.04% were significantly bothered and 0.89% were heavily bothered. The absence of statistically significant differences between both groups seems to indicate that training weather conditions did not influence the prevalence of SUI in elite female endurance athletes.

S027: Risks factors for stress urinary incontinence

S027: Risks factors for stress urinary incontinence

Autologous Muscle Derived Cells for Treatment of Stress Urinary Incontinence in Women

We assess the 12-month safety and potential efficacy of autologous muscle derived cells for urinary sphincter repair (Cook MyoSite Incorporated, Pittsburgh, Pennsylvania) in women with stress urinary incontinence. Pooled data from 2 phase I/II studies with identical patient selection criteria and outcome measures were analyzed. Enrolled patients had stress urinary incontinence refractory to prior treatment and no symptom improvement during the last 6 months. Patients received intrasphincter injection of 10 (16), 50 (16), 100 (24) or 200×10(6) (24) autologous muscle derived cells for urinary sphincter repair, derived from biopsies of each patient's quadriceps femoris. The primary outcome measure was safety, determined by incidence and severity of adverse events. Potential efficacy was measured by changes in 3-day voiding diaries, 24-hour pad tests, and UDI-6 and IIQ-7 scores. A total of 80 patients underwent injection of autologous muscle derived cells for urinary sphincter repair, and 72 completed diaries and pad tests at 12-month followup. No adverse events attributed to autologous muscle derived cells for urinary sphincter repair were reported. Higher dose groups tended to have greater percentages of patients with at least a 50% reduction in stress leaks and pad weight at 12-month followup. All dose groups had statistically significant improvement in UDI-6 and IIQ-7 scores at 12-month followup compared to baseline. Autologous muscle derived cells for urinary sphincter repair at doses of 10, 50, 100 and 200×10(6) cells appears safe. Efficacy data suggest a potential dose response with a greater percentage of patients responsive to higher doses.

Long-term effects of simulated childbirth injury on function and innervation of the urethra

Pudendal nerve and external urethral sphincter (EUS) injury during vaginal delivery are risk factors for stress urinary incontinence (SUI). Although most patients with short-term postpartum SUI regain continence within 1 year, they have a higher predisposition to develop recurrent SUI years later, suggesting a possible mechanistic relationship. In contrast, animal models generally recover spontaneously and have not been studied much in the long term. The aim of this study was to investigate the long-term effects of simulated childbirth injury in rats. Thirty-four Sprague-Dawley female rats underwent sham injury or pudendal nerve crush and vaginal distension (PNC + VD), a simulated childbirth injury. Nine weeks later, leak point pressure (LPP) and EUS electromyography (EMG) were recorded simultaneously. The pudendal nerve was harvested for histological analysis. EUS neuromuscular junctions (NMJs) and their innervation were qualitatively assessed using immunofluorescence. A t-test was used to compare quantitative outcomes between groups, with P < 0.05 indicating a significant difference. There was no significant difference in LPP or EUS EMG amplitude or firing rate between the two groups. Nonetheless after PNC + VD, NMJs in the EUS were diffuse and were innervated by tortuous and multiple axons, demonstrating that reinnervation of the EUS was still in progress. Although continence function recovered 9 weeks after simulated childbirth injury, innervation of EUS was not complete at this time point, suggestive of persistent neurogenic deficiency which when compounded by the effects of aging may lead to a delayed recurrence of SUI in this animal model with increased age.

Pelvic floor biometry during a first singleton pregnancy and the relationship with symptoms of pelvic floor disorders: a prospective observational study

To assess pelvic floor biometry during pregnancy and the correlation with symptoms of pelvic floor disorders in women. A prospective observational study. Antenatal clinic between August 2009 and May 2011. Nulliparous women in their first pregnancy. Pelvic floor was assessed by translabial ultrasound and symptoms of pelvic floor disorders were explored with a standardised questionnaire at each trimester. Pelvic floor biometry during pregnancy. A total of 405 (91.6%) women completed the study. As the pregnancy advanced, there was significant descent of the bladder neck (BN), cervix, and anorectal junction. The hiatal area (HA) was significantly enlarged, with a mean increase of 15.1 ± 24.8% at rest, and 24.7 ± 28.5% at Valsalva, at third trimester when compared with first trimester. Risk factors for stress urinary incontinence (SUI) were: descent of BN at Valsalva (OR 3.2, 95% CI 1.2-8.5), increase in HA at pelvic floor contraction (PFMC; OR 1.3, 95% CI 1.0-1.6), and increase in maternal age (OR 1.1, 95% CI 1.0-1.2), at first trimester; increase in HA at PFMC (OR 1.3, 95% CI 1.1-1.5) at second trimester; and descent of BN at rest (OR 2.3, 95% CI 1.1-4.9) and increase in maternal age (OR 1.1, 95% CI 1.02-1.2) at third trimester. Descent of anorectal junction (OR 1.5, 95% CI 1.1-1.9) and increase in HA at rest (OR 1.2, 95% CI 1.0-1.3) were factors for prolapse symptoms at second and third trimester, respectively. Pelvic floor changes begin during pregnancy. There was significant descent of the BN, cervix, and anorectal junction, and enlargement of the hiatal area, as the pregnancy advanced. SUI was associated with descent of the BN, and prolapse symptoms were associated with an increase in the hiatal area.

Risk Factors for the Development of Stress Urinary Incontinence in Women

Large-scale population-based surveys published in the past decade give new insights regarding risk factors for stress urinary incontinence (SUI) in women. Age plays a significant role in the development of all forms of urinary incontinence, but findings regarding the role of hormonal changes are inconsistent. Obesity is an increasingly prevalent health condition that was shown to have detrimental impact on SUI development, while weight reduction was proven to reduce SUI. Other modifiable risk factors, such as diabetes, also are related to SUI. Pregnancy, delivery, and pelvic floor surgery are risk factors discussed in the review. Recent genetic studies identified several genes encoding components of the extracellular matrix, which could be related to a predisposition to SUI. Identifying risk factors for SUI can facilitate prevention strategies in an aim to reduce SUI prevalence among women.

Estudo comparativo da capacidade de contração do assoalho pélvico em atletas de voleibol e basquetebol

As modalidades esportivas de alto impacto podem produzir um aumento exagerado e frequente na pressão intra-abdominal, um dos fatores desencadeadores da incontinência urinária de esforço (IUE) em atletas. Foi realizado um estudo com 20 atletas, sendo 10 de basquetebol e 10 de voleibol, do tipo quantitativo, observacional, transversal e comparativo, no qual foi comparada a capacidade de contração do assoalho pélvico (AP) entre atletas de voleibol e basquetebol, e então correlacionadas com sintomas de IUE. A avaliação das atletas foi composta por um questionário, a avaliação funcional do assoalho pélvico (AFA) e avaliação da capacidade de contração do AP através do Biofeedback Eletromiográfico Fênix®. Após a avaliação, não foi observada diferença estatisticamente significante com relação à capacidade de contração do assoalho pélvico entre atletas de basquetebol e voleibol; porém, ambas as modalidades apresentaram atletas com relatos de perda involuntária de urina mediante esforço físico, com maior proporção no grupo de atletas de basquetebol.

The correlations of incontinence-related quality of life measures with symptom severity and pathophysiology in women with primary stress urinary incontinence

We sought to explore the correlations of incontinence-related quality of life (QoL) measures with the symptom severity and pathophysiological factors for female stress urinary incontinence (SUI). We retrospectively reviewed the records of 707 women who had primary SUI. Clinical data for analysis included Ingelman-Sundberg scales, 1-h pad tests, incontinence-related QoL questionnaires comprising short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), ultrasound assessment of urethral support and urethral sphincter function determined by maximum urethral closure pressure and Valsalva leak point pressure. The correlations of incontinence-related QoL, measured by UDI-6 and IIQ-7 questionnaires, with the independent variables such as Ingelman-Sundberg scales, 1-h pad tests, urethral support and urethral sphincter function were investigated. The scores of item 3 of UDI-6 as well as the sum scores of UDI-6 and IIQ-7 had significant correlation with incontinence severity assessed by Ingelman-Sundberg scales and 1-h pad tests. However, only the scores of item 3 of UDI-6 were significantly correlated with the presence of bladder neck funneling on ultrasound and maximum urethral closure pressure. No correlations exist between sum scores of UDI-6 or IIQ-7 and the pathophysiological factors of SUI. Urogenital Distress Inventory-6 and IIQ-7 play important and complementary roles in comprehensive assessment for SUI, but are not identical to the pathophysiological factors.

O503 The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S236-S236 Free communication (oral) presentations O503 The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China Z. Lan, Z. LanSearch for more papers by this authorL. Jinghe, L. JingheSearch for more papers by this author Z. Lan, Z. LanSearch for more papers by this authorL. Jinghe, L. JingheSearch for more papers by this author First published: 06 October 2011 https://doi.org/10.1016/S0020-7292(09)60876-6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S236-S236 RelatedInformation

The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China

The aim of this study was to evaluate the prevalence and associated risk factors of urinary incontinence (UI) in Chinese women. In the cross-sectional survey, 20,000 Chinese women 20 years or older were randomly selected and interviewed with modified Bristol Female Lower Urinary Tract Symptoms questionnaires to estimate population prevalence rates and identify potential risk factors. A total of 19,024 women were included in the analysis and 976 excluded; qualified rate is 95% (19,024/20,000). Of the Chinese women aged from 20 to 99 years (mean +/- SD, 45 +/- 16 y), the overall prevalence rate of UI was 30.9%. Estimates of stress urinary incontinence (SUI), urge urinary incontinence, and mixed urinary incontinence prevalence were 18.9%, 2.6%, and 9.4%, with a corresponding proportional distribution of 61%, 8%, and 31%, respectively. The prevalence of mixed urinary incontinence increased with aging, whereas the prevalence of SUI peaked in the group of women aged 50 years and that of urge urinary incontinence in the group of women aged 70 years. Only 25% of women have consulted doctors on this issue. Through multivariable logistic regression analysis, we identified age, vaginal delivery, multiparity, alcohol consumption, central obesity (women's waist circumference, >/=80 cm), constipation, chronic pelvic pain, history of respiratory disease, gynecological events, pelvic surgery, and perimenopause and postmenopause status as potential risk factors for SUI, among which age, vaginal delivery, and multiparity are three major risk factors. Our findings suggest that the prevalence of UI is high in China, with SUI as the most common subtype. Age, vaginal delivery, and others are risk factors for SUI.

The study on the prevalence and associated risk factors of female urinary incontinence in Beijing women

To evaluate the prevalence, the clinical characteristics and associated risk factors of urinary incontinence in Beijing women. In the cross-sectional study, 5300 Beijing women aged over 20 years were interviewed through a questionnaire including International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS). Aged from 20 to 99 years old (mean 46 +/- 17). Divided into 8 groups every 10 years. 4812 cases are married. The overall prevalence of UI was 38.5% (2008/5221), among theses women, 22.9% (1197/5221), had stress incontinence, 2.8% (147/5221) urge incontinence and 12.4% (649/5221) mixed incontinence. In multiple logistic models, age, delivery mode, smoking, hypertension, constipation, body mass index, chronic pelvic pain (CPP) were relation factors for stress incontinence. The prevalence of urinary incontinence is high (38.5%). Urinary incontinence is major disease that affects female quality of life. 22.9% (1197/5221) of the incontinence women had stress urinary incontinence, 2.8% (147/5221) urge urinary incontinence and 12.4% (649/5221) mixed urinary incontinence. Old, vaginal delivery, smoking, hypertension, constipation, CPP and higher BMI are potential risk factors for stress urinary incontinence. Cesarean section are protective factors for stress urinary incontinence.

Abdominal obesity is associated with stress urinary incontinence in Korean women

This study investigated the relationship between abdominal obesity and stress urinary incontinence in Korean women. Women aged 30 and over, who visited the Department of Family Medicine of Asan Medical Center were recruited to participate in this study. Anthropometric measurements including body mass index (BMI) and waist circumference were taken, and associated factors of stress urinary incontinence was assessed by questionnaire. Stress urinary incontinence was significantly associated with physical work, vaginal delivery, and high waist circumference. In comparison with women in the lowest quartile of waist circumference, the odds ratios (OR) for stress urinary incontinence in women in the second, third, and fourth quartiles were increased significantly (1.79, 95% CI 1.07-2.98; 3.50, 95% CI 2.02-6.07; and 6.07, 95% CI 3.23-11.40, respectively). Our results indicate that high waist circumference may be a risk factor associated with stress urinary incontinence in women.

Factors Associated with Urinary Stress Incontinence in Primiparas

To evaluate obstetric and maternal risk factors for stress urinary incontinence in primiparas. From January 2001 to August 2002, 378 primiparas were interviewed about stress urinary incontinence 1 year after delivery. The association between symptoms of urinary stress incontinence and obstetric factors was assessed. Twenty-four (6%) primiparas had urinary stress incontinence after delivery. Maternal age was positively associated with urinary stress incontinence 1 year after delivery in primiparas who underwent vaginal delivery but not those who underwent cesarean section. There was a 4.5% greater prevalence of stress incontinence for each 5-year increase in age (coefficient B, 0.045; 95% confidence interval, CI, 0.04-0.51; p < 0.001). In primiparas who underwent cesarean section, performance of pelvic floor exercise was significantly related to a decrease in incontinence 1 year after delivery (odds ratio, 0.156; 95% CI, 0.034-0.713; p < 0.05). No such relationship was found in primiparas who underwent vaginal delivery. Body mass index, body weight gain during pregnancy, neonatal birth weight, head circumference, mode of delivery, and diabetes mellitus were not associated with stress incontinence 1 year after delivery in any primipara. Factors related to vaginal birth, including length of the first and second stages of labor, large perineal laceration, and instrumental delivery, also had no effect. For primiparas who underwent vaginal delivery, an increase in age was associated with increased risk of development of stress incontinence. Increased vulnerability of the pelvic floor with age might explain this finding. Pelvic floor exercise had a protective effect against postpartum stress incontinence in primiparas who underwent cesarean section. This reflects the fact that pregnancy per se carries a risk of stress incontinence. We recommend that primiparas perform pelvic floor exercises to prevent the development of postpartum stress incontinence.

Markers of collagen synthesis and degradation in urogenital tissue from women with and without stress urinary incontinence

Multiparity and obesity are risk factors for stress urinary incontinence (SUI), but collagen synthesis and metabolism in the urogenital tissue itself may also affect its function and control of micturition. Whether changes in synthesis or degradation of collagen are part of the etiology of SUI is not known and published studies show diverging results. The aims of the present study was to investigate collagen turnover in urogenital tissue in women with SUI (n=71) and in urologically healthy women (n=31). Markers of collagen synthesis and breakdown, the carboxy-terminal propeptide of type I procollagen (PICP), the carboxy-terminal telopeptide of type I collagen (ICTP), and the amino-terminal propeptide of procollagen III (PIIINP) were assayed in urogenital tissue homogenates and peripheral serum. In the total clinical material SUI patients were significantly older, had a significantly higher body mass index (BMI) and significantly lower serum PICP and tissue ICTP levels than the controls. When healthy controls were compared with SUI patients matched for age, BMI, parity, and hormonal/menopausal status (31 women in each group), the SUI patients had significantly lower serum concentrations of PICP and significantly lower tissue concentrations of PIIINP and ICTP than the controls. Within the total material of SUI patients, post-menopausal women with weak and strong HRT and pre-menopausal women had significantly lower S-ICTP concentrations than untreated post-menopausal patients. Significant negative correlations to parity were found for T-PIIINP and T-PICP and to BMI for T-ICTP. The low tissue collagen marker levels in women with SUI suggest a reduced collagen turnover, which may negatively affect tissue strength and elasticity.

▪ Obstetric Risk Factors for Stress Urinary Incontinence: A Population-Based Study

▪ Obstetric Risk Factors for Stress Urinary Incontinence: A Population-Based Study