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International Urogynecology Journal

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01-08-2015 | Original Article

Clustering of pelvic floor disorders 20 years after one vaginal or one cesarean birth

Authors: Maria Gyhagen, Sigvard Åkervall, Ian Milsom

Published in: International Urogynecology Journal | Issue 8/2015

Abstract

Introduction and hypothesis

The objective was to assess the prevalence and risk factors for co-occurring pelvic floor disorders (PFDs): urinary incontinence (UI), symptomatic pelvic organ prolapse (sPOP), and fecal incontinence (FI), 20 years after one vaginal (VD) or one cesarean (CS) delivery.

Methods

We carried out a registry-based national cohort study of primiparae who delivered during the period 1985–1988 and had no further deliveries. Medical Birth Registry data were linked to data from postal questionnaires distributed 20 years post-partum (response rate 65.2 %, n = 5,236). Main outcome measures were prevalence and risk factors for combined and isolated PFDs.

Results

The prevalence of any PFD was 46.5; 31.7 % had one symptom and 14.8 % had two or more. Co-occurring symptoms doubled after VD (17.1 %) compared with CS (8.4 %) (adjOR 2.26; 95 % CI 1.84–2.79). The strongest association was observed between VD and having all three symptoms (adjOR 5.20; 95 % CI 2.73–9.91), followed by the combination of sPOP and UI (adjOR 3.38; 95 % CI 2.24–5.10). The degree of frustration perceived by the women because of pelvic floor dysfunction increased with each additional co-occurring PFD (p < 0.001). The strongest risk factors for clustering of PFDs were: VD (OR 2.19; 95 % CI 1.75–2.73), family history (OR 2.03; 95 % CI 1.73–2.34), and ≥2 degree tear (OR 1.78; 95 % CI 1.24–2.55). Vacuum extraction and episiotomy were not risk factors.

Conclusions

The prevalence of co-occurring PFDs was high and was doubled in women after VD compared with CS. Women with UI most likely had it as an isolated symptom, whereas FI and sPOP more often occurred in combination.

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Title: Clustering of pelvic floor disorders 20 years after one vaginal or one cesarean birth
Authors: Maria Gyhagen
Sigvard Åkervall
Ian Milsom
Publication date: 01-08-2015
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 8/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2663-3

At a glance: The STEP trials

Springer Medicine

Clustering of pelvic floor disorders 20 years after one vaginal or one cesarean birth

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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