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Post partum incontinence

Dimos Sioutis, Ranee Thakar, Abdul H Sultan
OBJECTIVES: To identify the accuracy of clinically diagnosed OASIS using 3D endoanal ultrasound and compare symptoms and anal manometry measurements between those whose anal sphincters were adequately repaired to those who had persistent anal sphincter defects. METHODS: The endoanal scan images of women who sustained OASIS and attended the perineal clinic over a 10 year period (2003 - 2013) were re-analysed from data entered prospectively of women with clinically diagnosed and repaired OASIS...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
Jenny Kurz, Diane Borello-France
BACKGROUND AND PURPOSE: Postpartum women with pelvic organ prolapse (POP) and urinary incontinence (UI) are often managed by physical therapists specializing in women's health. Movement system impairments often co-exist in this patient population. The purpose of this case study was to describe the physical therapy management of a post-partum female with POP complicated by additional pelvic symptoms. CASE DESCRIPTION: A 31-year-old post-partum female presented with POP, diastasis recti, UI, and constipation...
September 1, 2016: Physical Therapy
Marie-Victoire Sénat, Loïc Sentilhes, Anne Battut, Dan Benhamou, Sarah Bydlowski, Anne Chantry, Xavier Deffieux, Flore Diers, Muriel Doret, Chantal Ducroux-Schouwey, Florent Fuchs, Geraldine Gascoin, Chantal Lebot, Louis Marcellin, Genevieve Plu-Bureau, Brigitte Raccah-Tebeka, Emmanuel Simon, Gérard Bréart, Loïc Marpeau
OBJECTIVE: To make evidence-based recommendations for the postpartum management of women and their newborns, regardless of the mode of delivery. MATERIAL AND METHODS: Systematic review of articles from the PubMed database and the Cochrane Library and of recommendations from the French and foreign societies or colleges of obstetricians. RESULTS: Because breast-feeding is associated with reductions in neonatal, infantile, and childhood morbidity (lower frequency of cardiovascular, infectious, and atopic diseases and infantile obesity) (LE2) and improved cognitive development in children (LE2), exclusive and extended breastfeeding is recommended (grade B) for at least 4-6 months (professional consensus)...
July 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Kari Bø, Gunvor Hilde, Merete Kolberg Tennfjord, Marie Ellstrøm Engh
AIMS: The aim of the present study was to compare vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength and endurance, and prevalence of urinary incontinence (UI) at 6 weeks postpartum, in women with and without lateral or mediolateral episiotomy. METHODS: Two hundred and thirty-eight nulliparous pregnant women, mean age 28.5 years (SD 4.2) and pre-pregnancy BMI 23.8 (SD 4.0) participated in the study. Lateral or mediolateral episiotomy was only performed for indications such as fetal distress or imminent risk of severe perineal tear...
April 5, 2016: Neurourology and Urodynamics
David Yohay, Adi Y Weintraub, Naama Mauer-Perry, Carmel Peri, Rachel Kafri, Zehava Yohay, Asher Bashiri
OBJECTIVE: To investigate the prevalence of pelvic floor disorders (PFD) in a cohort of Israeli women at late pregnancy and three months postpartum, to define changes in PFD rates and to evaluate various obstetrical factors that may correlate with these changes. METHODS: A prospective longitudinal cohort study was conducted between March and July 2014. The PFDI-20 questionnaire (validated in the Hebrew language) was used to evaluate pelvic floor distress symptoms 24h and 3 months after delivery (representing the third trimester and post-partum period, respectively)...
May 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
M-V Sénat, L Sentilhes, A Battut, D Benhamou, S Bydlowski, A Chantry, X Deffieux, F Diers, M Doret, C Ducroux-Schouwey, F Fuchs, G Gascoin, C Lebot, L Marcellin, G Plu-Bureau, B Raccah-Tebeka, E Simon, G Bréart, L Marpeau
OBJECTIVE: To determine the post-partum management of women and their newborn whatever the mode of delivery. MATERIAL AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Because breastfeeding is associated with a decrease in neonatal morbidity (lower frequency of cardiovascular diseases, infectious, atopic or infantile obesity) (EL2) and an improvement in the cognitive development of children (EL2), exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (Professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Claudia Oblasser, Janice Christie, Christine McCourt
OBJECTIVES: the vaginal use of cones or balls aims to increase muscle performance and thereby prevent or treat urinary incontinence. To date, no systematic review has focused on the effectiveness of these devices specifically during the postpartum period. The objectives of this review were: to compare the effectiveness of vaginal cones or balls for improvement of pelvic floor muscle performance and urinary continence in the postpartum period to no treatment, placebo, sham treatment or active controls; to gather information on effect on perineal descent or pelvic organ prolapse, adverse effects and economical aspects...
November 2015: Midwifery
Maurizio Serati, Maria Carmela Di Dedda, Giorgio Bogani, Paola Sorice, Antonella Cromi, Stefano Uccella, Martina Lapenna, Marco Soligo, Fabio Ghezzi
INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate the role of the maternal position at the time of delivery on the onset of de novo symptoms of urinary incontinence (UI) in the post-partum period. METHODS: This prospective study evaluated the data of consecutive women undergoing labour and delivery, between January 2014 and July 2014. We included only women with a singleton pregnancy undergoing vaginal delivery. During the study period, patients chose to deliver in the position that they considered the most comfortable...
February 2016: International Urogynecology Journal
E K Hutton, M E Hannah, S Ross, K S Joseph, A Ohlsson, E V Asztalos, A R Willan, A C Allen, B A Armson, A Gafni, K Mangoff, J J Sanchez, J F Barrett
OBJECTIVE: To compare outcomes at 3 months post partum for women randomised to give birth by planned caesarean section (CS) or by planned vaginal birth (VB) in the Twin Birth Study (TBS). DESIGN: We invited women in the TBS to complete a 3-month follow-up questionnaire. SETTING: Two thousand and eight hundred and four women from 25 countries. POPULATION: Two thousand and five hundred and seventy women (92% response rate)...
November 2015: BJOG: An International Journal of Obstetrics and Gynaecology
A Villot, X Deffieux, G Demoulin, A-L Rivain, C Trichot, T Thubert
This was a comprehensive literature review using Pubmed, Medline, Embase and Cochrane, whose aim was to analyse the prevalence of anal sphincter injuries, their risk factors, their management and their functional prognosis. The prevalence of 3rd and 4th degree perineal tears varies between studies from 2.95% regardless the parity to 25% in nulliparous women. Twenty-eight percent to 48% of these lacerations were clinically occult. Perineal tears were associated with (multivariate analysis) forceps (6.021 [IC 95% 1...
November 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Ananias C Diokno, Theophilus Ogunyemi, Mohammad-Reza Siadat, Suzan Arslanturk, Kim A Killinger
PURPOSE: Urinary incontinence (UI) is a chronic, costly condition that impairs quality of life. To identify older women most at risk, the Medical Epidemiologic and Social Aspects of Aging (MESA) datasets were mined to create a set of questions that can reliably predict future UI. METHODS: MESA data were collected during four household interviews at approximately 1 year intervals. Factors associated with becoming incontinent at the second interview (HH2) were identified using logistic regression (construction datasets)...
July 2015: International Urology and Nephrology
T Thubert, E Bakker, X Fritel
Our goal is to provide an update on the results of pelvic floor rehabilitation in the treatment of urinary incontinence and genital prolapse symptoms. Pelvic floor muscle training allows a reduction of urinary incontinence symptoms. Pelvic floor muscle contractions supervised by a healthcare professional allow cure in half cases of stress urinary incontinence. Viewing this contraction through biofeedback improves outcomes, but this effect could also be due by a more intensive and prolonged program with the physiotherapist...
May 2015: Gynécologie, Obstétrique & Fertilité
Maria Gyhagen, Sigvard Åkervall, Ian Milsom
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...
August 2015: International Urogynecology Journal
Claudia Oblasser, Janice Christie, Christine McCourt
AIM: To identify, critically appraise and synthesize the best current evidence on the use of vaginal cones or balls to improve pelvic floor muscle performance and urinary continence in women post partum. BACKGROUND: The vaginal use of cones or balls is a pelvic floor muscle training method that aims to enhance muscle performance and thereby prevent or treat urinary incontinence. Nonetheless to date, no systematic review has focused on the effectiveness of these devices specifically during the postpartum period...
April 2015: Journal of Advanced Nursing
Corrado Cescon, Diego Riva, Vita Začesta, Kristina Drusany-Starič, Konstantinos Martsidis, Olexander Protsepko, Kaven Baessler, Roberto Merletti
INTRODUCTION AND HYPOTHESIS: A correlation exists between external anal sphincter (EAS) damage during birth and the subsequent development of fecal incontinence. This study evaluated the effect of delivery-related trauma on EAS innervation by means of intra-anal EMG performed with a rectal probe with 16 silver electrodes equally spaced along the circumference, before and after delivery. METHODS: Pre-partum EMG measurements were performed on 511 women, by nine clinical partners from five European countries at the 28th to 34th gestational weeks and the 6th to 8th post-delivery weeks; 331 women returned, after delivery, for the second test...
November 2014: International Urogynecology Journal
Shruti Atul Prabhu, Sunita S Shanbhag
BACKGROUND: To study the prevalence and risk factors of urinary incontinence in tribal women and to assess the treatment seeking behavior of affected women. METHODS: A cross-sectional descriptive study was conducted in Khardi, a tribal village, selected by random sampling, in Thane district, Maharashtra, India during the period October 2010 to January 2011. All women aged 20 years and above were selected for the study except pregnant and lactating women and those with neurological disorders affecting bladder continence...
July 2013: Journal of Research in Health Sciences
Hannah Woolhouse, Deirdre Gartland, Susan Perlen, Susan Donath, Stephanie J Brown
OBJECTIVE: to investigate the relationship between maternal physical health problems and depressive symptoms in the first year after childbirth. DESIGN: prospective pregnancy cohort study. SETTING: Melbourne, Victoria, Australia. POPULATION: 1507 nulliparous women. METHODS: women were recruited from six public hospitals between six and 24 weeks gestation. Written questionnaires were completed at recruitment and at three, six and 12 months post partum...
March 2014: Midwifery
Regina Ruiz de Viñaspre Hernández, Encarnación Rubio Aranda, Concepción Tomás Aznar
OBJECTIVE: to analyse the association between urinary incontinence and maternal weight, and its variations in pregnancy and post partum. DESIGN: observational study of a cohort of women from the start of pregnancy until six months post partum. SETTING: Hospital San Pedro in La Rioja, Spain. PARTICIPANTS: 402 pregnant women without urinary incontinence at the start of pregnancy. MEASUREMENTS AND FINDINGS: the dependent variable was urinary incontinence, assessed using the Urogenital Distress Inventory-Short Form questionnaire...
December 2013: Midwifery
Elisabeth Zetlitz, Miriam Manook, Alison MacLeod, Stuart Hamilton
INTRODUCTION: Post-partum vaginal laxity is a problem encountered by many women. More uncommon is a resulting vaginal defect. In most cases of laxity, a period of extensive physiotherapy can strengthen the pelvic muscles enough for symptoms to be minimized. However, this is not the case once there is a tissue defect. AIM: To present a new reconstructive method for patients with posterior vaginal wall defects. METHODS: We present a case of a 38-year-old female who, 12 years prior to presentation, had a vaginal delivery...
October 2013: Journal of Sexual Medicine
Ylenia Fonti, Rosalba Giordano, Alessandra Cacciatore, Mattea Romano, Beatrice La Rosa
Pelvic-perineal dysfunctions, are the most common diseases in women after pregnancy. Urinary incontinence and genital prolapsy, often associated, are the most important consequences of childbirth and are determined by specific alterations in the structure of neurological and musculo-fascial pelvic support.Causation is difficult to prove because symptom occur remote from delivery.Furthermore it is unclear whether changes are secondary to the method of childbirth or to the pregnancy itself.This controversy fuels the debate about whether or not women should be offered the choice of elective caesarean delivery to avoid the development of subsequent pelvic floor disfunction...
October 2009: Journal of Prenatal Medicine
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