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International Urogynecology Journal

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01-10-2011 | Original Article

Urodynamic indices and pelvic organ prolapse quantification 3 months after vaginal delivery in primiparous women

Authors: Clifford Y. Wai, Donald D. McIntire, Shanna D. Atnip, Joseph I. Schaffer, Steven L. Bloom, Kenneth J. Leveno

Published in: International Urogynecology Journal | Issue 10/2011

Abstract

Introduction and hypothesis

This study aims to describe multichannel urodynamic indices and pelvic organ prolapse quantification (POP-Q) in primiparous women 3 months after vaginal delivery.

Methods

This was a secondary analysis of a group of women who had been randomized to either coached or non-coached pushing during the second stage of labor. Primiparous women were evaluated with POP-Q examination and multichannel urodynamic testing 3 months after vaginal delivery.

Results

Of 128 women evaluated, the cumulative stage of prolapse was distributed as 4.7% stage 0, 39% stage I, 56% stage II, and none with stage III prolapse or greater. For the anterior compartment, most had stage II prolapse. Stage I prolapse predominated for both the central and posterior compartments. Of the women, 14.1% had urodynamic stress incontinence, 12.5% had detrusor overactivity, and 6% had both.

Conclusions

In a predominantly Hispanic primiparous population, ICS POP-Q stage II prolapse of the vagina, urodynamic stress incontinence, and detrusor overactivity are common findings at a 3-month postpartum assessment.

Allen RE, Hosker GL, Smith ARB, Warrell DE (1990) Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol 97:770–779PubMedCrossRef

Tetzschner T, Sørensen M, Jønsson L, Lose G, Christiansen J (1997) Delivery and pudendal nerve function. Acta Obstet Gynecol Scand 76:324–331PubMedCrossRef

Snooks SJ, Setchell M, Swash M, Henry MM (1984) Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet 2:546–550PubMedCrossRef

Peschers U, Schaer G, Anthuber C, Delancey JO, Schuessler B (1996) Changes in vesical neck mobility following vaginal delivery. Obstet Gynecol 88:1001–1006PubMedCrossRef

Sultan AH, Kamm MA, Hudson CN (1994) Pudendal nerve damage during labour: prospective study before and after childbirth. Br J Obstet Gynaecol 101:22–28PubMedCrossRef

O’Boyle AL, O’Boyle JD, Ricks RE, Patience TH, Calhoun B, Davis G (2003) The natural history of pelvic organ support in pregnancy. Int Urogynecol J Pelvic Floor Dysfunct 14:46–49PubMedCrossRef

Sze EH, Sherard GB 3rd, Dolezal JM (2002) Pregnancy, labor, delivery, and pelvic organ prolapse. Obstet Gynecol 100:981–986PubMedCrossRef

Handa VL, Nygaard I, Kenton K, Cundiff GW, Ghetti C, Ye W (2009) Pelvic floor disorders network. Pelvic organ support among primiparous women in the first year after childbirth. Int Urogynecol J Pelvic Floor Dysfunct 20:1407–1411PubMedCrossRef

Schaffer JI, Bloom SL, Casey BM, McIntire DD, Nihira MA, Leveno KJ (2005) A randomized trial of the effects of coached vs uncoached maternal pushing during the second stage of labor on postpartum pelvic floor structure and function. Am J Obstet Gynecol 192:1692–1696PubMedCrossRef

10.

Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JOL, Klarshov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef

11.

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178PubMedCrossRef

12.

Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE et al (1996) Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 175:1467–1470PubMedCrossRef

13.

Larsen WI, Yavorek T (2007) Pelvic prolapse and urinary incontinence in nulliparous college women in relation to paratrooper training. Int Urogynecol J Pelvic Floor Dysfunct 18:769–771PubMedCrossRef

14.

Larsen WI, Yavorek TA (2006) Pelvic organ prolapse and urinary incontinence in nulliparous women at the United States Military Academy. Int Urogynecol J Pelvic Floor Dysfunct 17:208–210PubMedCrossRef

15.

Swift SE (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol 183:277–285PubMedCrossRef

16.

Weber AM, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski RR et al (2001) The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct 12:178–186PubMedCrossRef

17.

Swift SE, Tate SB, Nicholas J (2003) Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 189:372–379PubMedCrossRef

18.

Gutman RE, Ford DE, Quiroz LH, Shippey SH, Handa VL (2008) Is there a pelvic organ prolapse threshold that predicts pelvic floor symptoms? Am J Obstet Gynecol 199:683.e1–683.e7CrossRef

19.

Meyer S, Schreyer A, De Grandi P, Hohlfeld P (1998) The effects of birth on urinary continence mechanisms and other pelvic-floor characteristics. Obstet Gynecol 92:613–618PubMedCrossRef

20.

Chaliha C, Bland JM, Monga A, Stanton SL, Sultan AH (2000) Pregnancy and delivery: a urodynamic viewpoint. BJOG 107:1354–1359PubMedCrossRef

Title: Urodynamic indices and pelvic organ prolapse quantification 3 months after vaginal delivery in primiparous women
Authors: Clifford Y. Wai
Donald D. McIntire
Shanna D. Atnip
Joseph I. Schaffer
Steven L. Bloom
Kenneth J. Leveno
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 10/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-011-1438-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Urodynamic indices and pelvic organ prolapse quantification 3 months after vaginal delivery in primiparous women

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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