Influence of parity and operative vaginal delivery on the prevalence of stress, urge and mixed urinary incontinence, and overactive bladder in Saudi Arabia

Abstract EN

Objective : To evaluate the contribution of member and mode of vaginal deliveries to the occurrence of stress, urge and mixed urinary incontinence and overactive bladder.

Design: A prospective observational case-control study, Stetting : Outpatient gynecology clinics of Umm Al-Qura University associated hospitals.

Population : The study involved 600 women satisfying the selection criteria seen for counseling and/or treatment of urinary incontinence or overactive bladder, or observed for routine gynecological examination or minor gynecological complaints without any symptoms related to these disorders.

Methods : Cases were 450 women classified into 3 groups; Group I (one or two vaginal deliveries), Group II (three or more vaginal deliveries) and Group III (one or more instrumental vaginal deliveries).

Controls were 150 nulliparous women observed during the study period in the same gynecology clinic.

Urogenital symptoms were measured using a questionnaire with questions from the Urogenital Distress Inventory.

Main outcome Measures: Parity and operative vaginal delivery as obstetric determinants of stress, urge, and mixed urinary incontinence and overactive bladder.

Results: In comparison with nuliiparae (Controls), a history of one or two vaginal deliveries (Group 1) was associated with the risk of stress, mixed and overall urinary incontinence (0.7 vs.

6.7, 1.3 vs.

9, 3 and 5.3 vs.

23.3 respeclively ; P < 0.05).

Likewise, in comparison with nuliiparae (Controls), a history of three or more vaginal deliveries (Group II) was associated with the risk of stress, mixed and overall urinary incontinence and overactive bladder (0.7 vs.

14.7, 1.3 vs.

12.0, 5.3 vs.

38.0 and 2.7 vs.

11.3 respectively ; P < 0.05).

However, in comparison with women with one or two vaginal deliveries (Group I), a history of three or more vaginal deliveries (Group II) was associated with the risk of overactive bladder (3.3 vs.

11.3; P < 0.05).

When compared with nuliiparae (Controls), a history of one or more operative vaginal deliveries (Group III) was associated with the risk of stress, mixed and overall urinary incontinence (0.7 vs.

6.7, 1.3 vs.

6.0 and 5.3 vs.

18.0 respectively; P < 0.05).

Conclusions: The number of vaginal births was associated with the risk of stress and mixed urinary incontinence and overactive bladde.

Ahislory operative vaginal delivery was directly associated with the risk of stress and mixed urinary incontinence.

Further studies are recommended to investigate other factors in obstetric practice related to the risk of urinary incontinence.