Effects of vaginal and cessarean deliveries on bladder neck mobility and stress urinary incontinence

Urinary incontinence is a health problem which can effect the qualitiy of life negatively and can be seen among men and women of any age. Prevalence of urinary incontinence in women aged over 30 is approximately 14%, primipar 2-5% and post- menopausal 30%. Effect of childbirt and pregnancy on urinary continence is controversial. The importance of evaluating the population under risk of developing urinary incontinence increases considering the impact on quality of life and cost of treatment in long term.This study examined the effects of vaginal and cessarean deliveries and pregnancy on urinary continence on women selected randomly who presented to he Wonen?s Health Outpatient Clinic in Celal Bayar University Hospital, between January 2009 and June 2009. Among these 163 patients, 56 were primipar, 66 were delivered vaginaly and 37 were delivered by cessarean section and 4 patient had vaginal birth after cessarean section. The patients were evaluated with anamnesis, clinical examination, POP-Q, stres and ped tests and perineal ultrasonography based on the International Continence Society criterias. Results were compared with the current literature.According to the results pregnancy increased the bladder neck mobility and prevalence of urinary incontinence, moreover, this increase was higher among patients delivered vaginaly, although, insignificant statisticaly. There was a noticeable difference on clinical examination findings and urinary incontinence, however, it did not show statistical significance. This study suggests that the perineal ultrasonograpy has not a diagnostic value alone, however, it would be highly beneficial if it is used with POP-Q and ped tests evaluating lower genital tract anatomy preoperatively and chosing the best surgical treatment technique.