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Medline ® Abstract for Reference 111

of 'Urinary incontinence and pelvic organ prolapse associated with pregnancy and childbirth'

Parity and route of delivery: does cesarean delivery reduce bladder symptoms later in life?
Handa VL, Harvey L, Fox HE, Kjerulff KH
Am J Obstet Gynecol. 2004;191(2):463.
OBJECTIVE: This study was undertaken to investigate the impact of reproductive factors on the prevalence of urinary symptoms.
STUDY DESIGN: Participants were women scheduled for hysterectomy (n=1299). Before surgery, urinary symptoms were assessed by questionnaire. Multiple logistic regression analysis was used to investigate the association between bladder symptoms and parity, route of delivery, and other characteristics.
RESULTS: Stress incontinence and urinary urgency were more prevalent among parous than nulliparous women (P<.01). Controlling for parity and other characteristics, women who had a history of cesarean delivery were significantly less likely to report stress incontinence than women with a history of vaginal delivery (odds ratio 0.60; 95% CI 0.39-0.93).
CONCLUSION: Women who have undergone vaginal delivery are more likely to report stress incontinence than women who have delivered by cesarean section. Although this suggests that cesarean delivery might reduce incontinence later in life, further research is needed to clarify the long-term risks, benefits, and costs of cesarean delivery.
Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA.