Araştırma Makalesi
Yıl 2021,
Cilt: 18 Sayı: 4, 1010 - 1016, 31.12.2021
Öz
Amaç: Doğum şekli ve parite sayısının pelvik organ prolapsusu (POP) ve üriner inkontinans (UI) gelişimine etkisini araştırmak.
Gereç ve yöntem: 2007-2012 yılları arasında POP ve UI ameliyatı geçiren 1500 kadın geriye dönük olarak değerlendirildi. Dışlama kriterlerinden sonra 875 kadın dahil edildi. POP ameliyatı öyküsü olan 353 kadın, POP ameliyatı olmayan 129 kontrol ile karşılaştırıldı ve anti-inkontinans ameliyatı öyküsü olan 201 hasta, böyle bir ameliyatı olmayan 192 kontrol ile karşılaştırıldı. Olası faktörlerin POP ve UI gelişimi üzerindeki çoklu etkisi lojistik regresyon ile belirlendi.
Bulgular: POP grubu ve kontroller ile anti inkontinans cerrahisi grubu ve kontrollerin özellikleri parite sayısı dışında benzerdi. Parite sayısı arttıkça POP ameliyatı olma riski daha yüksekti. En yüksek risk, 5 ve daha fazla doğum öyküsü olan kadınlarda bulundu. UI için multiparite bir risk faktörü olarak göründü, ancak inkontinans cerrahisine girme riski artan parite sayısı ile artmadı. Doğum şekli, hem POP hem de anti-inkontinans grubu için bir risk faktörü değildi.
Sonuç: Parite sayısı arttıkça POP riski artar ve multiparite de UI için bir risk faktörüdür. Birden fazla doğum planlayan kadınlar bu durumdan haberdar edilmelidir. Doğum modunun etkisi net olarak gösterilmediğinden, pelvik taban disfonksiyon insidansının uygun obstetrik bakım ile azaltılabileceğine inanıyoruz.
Anahtar Kelimeler
Kaynakça
- 1. Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017 Feb; 28(2):191-213.
- 2. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstetrics and Gynecology. 2010;116(5):1096-100.
- 3. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61(1):37-49.
- 4. DuBeau CE, Kuchel GA, Johnson T, 2nd, Palmer MH, Wagg A, Fourth International Consultation on I. Incontinence in the frail elderly: report from the 4th International Consultation on Incontinence. Neurourology and Urodynamics. 2010;29(1):165-78
- 5. Ebbesen MH, Hunskaar S, Rortveit G, Hannestad YS. Prevalence, incidence and remission of urinary incontinence in women : longitudinal data from the Norwegian HUNT study ( EPINCONT). BMC Urol. BMC Urology; 2013;13(1):1.
- 6. Khullar V, Sexton CC, Thompson CL, Milsom I, Ebel Bitoun C, Coyne K. The relationship Between BMI and Urinary Incontinence Subgoups: Result From EpiLUTS. Neurourol Urodyn.2014;33:392–9.
- 7. Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane Review. International Urogynecology Journal. 2011;22(11):1445-57.
- 8. Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. AJOG. 1999;180(2 Pt 1):299-305.
- 9. Åkervall S, Al-Mukhtar Othman J, Molin M, Gyhagen M.Symptomatic pelvic organ prolapse in middle-aged women: a national matched cohort study on the influence of childbirth. Am J Obstet Gynecol. 2020 Apr;222(4):356.e1-356.e14.
- 10. Lawrence JM, Lukacz ES, Liu IL, Nager CW, Luber KM. Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser Permanente Continence Associated Risk Epidemiology Study. Diabetes Care. 2007;30(10):2536-41.
- 11. Chen B, Yeh J. Alterations in connective tissue metabolism in stress incontinence and prolapse. The Journal of Urology. 2011;186(5):1768-72.
- 12. Busacchi P, Perri T, Paradisi R, Oliverio C, Santini D, Guerrini S, et al. Abnormalities of somatic peptide-containing nerves supplying the pelvic floor of women with genitourinary prolapse and stress urinary incontinence. Urology. 2004;63(3):591-5.
- 13. Romano M, Cacciatore A, Giordano R, La Rosa B. Postpartum period: three distinct but continuous phases. Journal of Prenatal Medicine. 2010;4(2):22-5.
- 14. Kepenekci I, Keskinkilic B, Akinsu F, Cakir P, Elhan AH, Erkek AB, et al. Prevalence of pelvic floor disorders in the female population and the impact of age, mode of delivery, and parity. Diseases of the Colon and Rectum. 2011;54(1):85-94
- 15. Sensoy N, Dogan N, Ozek B, Karaaslan L. Urinary incontinence in women: prevalence rates, risk factors and impact on quality of life. Pakistan Journal of Medical Sciences. 2013;29(3):818-22.
- 16. Zhu L, Bian XM, Long Y, Lang JH. Role of different childbirth strategies on pelvic organ prolapse and stress urinary incontinence: a prospective study. Chinese Medical Journal. 2008;121(3):213-5
- 17. Connolly TJ, Litman HJ, Tennstedt SL, Link CL, McKinlay JB. The effect of mode of delivery, parity, and birth weight on risk of urinary incontinence. International Urogynecology Journal and Pelvic Floor Dysfunction. 2007;18(9):1033-42.
- 18. Murad-Regadas SM, Regadas FS, Rodrigues LV, Furtado DC, Gondim AC, Dealcanfreitas ID. Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions. Arquivos de Gastroenterologia. 2011;48(4):265-9.
- 19. Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. BJOG. 1997;104(5):579-85.
- 20. Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG : An International Journal of Obstetrics and Gynaecology. 2013;120(2):152-60.
- 21. Friedman S, Blomquist JL, Nugent JM, McDermott KC, Munoz A, Handa VL. Pelvic muscle strength after childbirth. Obstetrics and Gynecology. 2012;120(5):1021-8.
- 22. Kearney R, Miller JM, Ashton-Miller JA, DeLancey JO. Obstetric factors associated with levator ani muscle injury after vaginal birth. Obstetrics and Gynecology. 2006;107(1):144-9.
- 23. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S, Norwegian ES. Urinary incontinence after vaginal delivery or cesarean section. The New England Journal of Medicine. 2003;348(10):900-7.
- 24. Whyte H, Hannah ME, Saigal S, Hannah WJ, Hewson S, Amankwah K, et al. Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. AJOG. 2004;191(3):864-71.
- 25. Wilson PD, Herbison RM, Herbison GP. Obstetric practice and the prevalence of urinary incontinence three months after delivery. BJOG. 1996;103(2):154-61.
- 26. Leijonhufvud A, Lundholm C, Cnattingius S, Granath F, Andolf E, Altman D. Risks of stress urinary incontinence and pelvic organ prolapse surgery in relation to mode of childbirth. AJOG. 2011;204(1):70 e1-7.
- 27. Blomquist JL, Muñoz A, Carroll M, Handa VL.Association of Delivery Mode With Pelvic Floor Disorders After Childbirth. JAMA. 2018 Dec 18;320(23):2438-2447.
- 28. Novellas S, Chassang M, Verger S, Bafghi A, Bongain A, Chevallier P. MR features of the levator ani muscle in the immediate postpartum following cesarean delivery. International Urogynecology Journal. 2010;21(5):563-8.
The impact of delivery mode and parity on development of pelvic organ prolapse and urinary incontinence
Öz
Aim: To investigate the effect of delivery mode and parity number on development of pelvic organ prolapse (POP) and urinary incontinence (UI).
Materials and methods: 1500 women who had undergone surgery for POP and UI between 2007-2012 were retrospectively evaluated. After exclusion criteria, 875 women were included. 353 women with history of POP surgery were compared with 129 controls who had no POP and 201 patients with history of anti-incontinence surgery were compared with 192 controls who had no such surgery. Multiple effect of possible factors on the development of POP and UI was determined by logistic regression.
Results: The characteristics of POP group and the controls, as well as anti incontinence surgery group and controls were similar, except parity number. The risk of having a POP surgery was higher with increasing number of parity. The highest risk was found in women with a history of 5 and more deliveries. For UI, multiparity seemed as a risk factor, however the risk of undergoing incontinence surgery did not increase with increasing number of parity. Delivery mode was not a risk factor for either POP or anti-incontinence group.
Conclusion: The risk of POP increases with increasing number of parity, and also multiparity is a risk factor for UI. Women planning more than one delivery should be informed about this concern. Since the impact of delivery mode has not been shown clearly, we believe the incidence of pelvic floor dysfunction can be decreased with proper obstetric
Anahtar Kelimeler
Kaynakça
- 1. Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017 Feb; 28(2):191-213.
- 2. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstetrics and Gynecology. 2010;116(5):1096-100.
- 3. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61(1):37-49.
- 4. DuBeau CE, Kuchel GA, Johnson T, 2nd, Palmer MH, Wagg A, Fourth International Consultation on I. Incontinence in the frail elderly: report from the 4th International Consultation on Incontinence. Neurourology and Urodynamics. 2010;29(1):165-78
- 5. Ebbesen MH, Hunskaar S, Rortveit G, Hannestad YS. Prevalence, incidence and remission of urinary incontinence in women : longitudinal data from the Norwegian HUNT study ( EPINCONT). BMC Urol. BMC Urology; 2013;13(1):1.
- 6. Khullar V, Sexton CC, Thompson CL, Milsom I, Ebel Bitoun C, Coyne K. The relationship Between BMI and Urinary Incontinence Subgoups: Result From EpiLUTS. Neurourol Urodyn.2014;33:392–9.
- 7. Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane Review. International Urogynecology Journal. 2011;22(11):1445-57.
- 8. Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. AJOG. 1999;180(2 Pt 1):299-305.
- 9. Åkervall S, Al-Mukhtar Othman J, Molin M, Gyhagen M.Symptomatic pelvic organ prolapse in middle-aged women: a national matched cohort study on the influence of childbirth. Am J Obstet Gynecol. 2020 Apr;222(4):356.e1-356.e14.
- 10. Lawrence JM, Lukacz ES, Liu IL, Nager CW, Luber KM. Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser Permanente Continence Associated Risk Epidemiology Study. Diabetes Care. 2007;30(10):2536-41.
- 11. Chen B, Yeh J. Alterations in connective tissue metabolism in stress incontinence and prolapse. The Journal of Urology. 2011;186(5):1768-72.
- 12. Busacchi P, Perri T, Paradisi R, Oliverio C, Santini D, Guerrini S, et al. Abnormalities of somatic peptide-containing nerves supplying the pelvic floor of women with genitourinary prolapse and stress urinary incontinence. Urology. 2004;63(3):591-5.
- 13. Romano M, Cacciatore A, Giordano R, La Rosa B. Postpartum period: three distinct but continuous phases. Journal of Prenatal Medicine. 2010;4(2):22-5.
- 14. Kepenekci I, Keskinkilic B, Akinsu F, Cakir P, Elhan AH, Erkek AB, et al. Prevalence of pelvic floor disorders in the female population and the impact of age, mode of delivery, and parity. Diseases of the Colon and Rectum. 2011;54(1):85-94
- 15. Sensoy N, Dogan N, Ozek B, Karaaslan L. Urinary incontinence in women: prevalence rates, risk factors and impact on quality of life. Pakistan Journal of Medical Sciences. 2013;29(3):818-22.
- 16. Zhu L, Bian XM, Long Y, Lang JH. Role of different childbirth strategies on pelvic organ prolapse and stress urinary incontinence: a prospective study. Chinese Medical Journal. 2008;121(3):213-5
- 17. Connolly TJ, Litman HJ, Tennstedt SL, Link CL, McKinlay JB. The effect of mode of delivery, parity, and birth weight on risk of urinary incontinence. International Urogynecology Journal and Pelvic Floor Dysfunction. 2007;18(9):1033-42.
- 18. Murad-Regadas SM, Regadas FS, Rodrigues LV, Furtado DC, Gondim AC, Dealcanfreitas ID. Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions. Arquivos de Gastroenterologia. 2011;48(4):265-9.
- 19. Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. BJOG. 1997;104(5):579-85.
- 20. Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG : An International Journal of Obstetrics and Gynaecology. 2013;120(2):152-60.
- 21. Friedman S, Blomquist JL, Nugent JM, McDermott KC, Munoz A, Handa VL. Pelvic muscle strength after childbirth. Obstetrics and Gynecology. 2012;120(5):1021-8.
- 22. Kearney R, Miller JM, Ashton-Miller JA, DeLancey JO. Obstetric factors associated with levator ani muscle injury after vaginal birth. Obstetrics and Gynecology. 2006;107(1):144-9.
- 23. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S, Norwegian ES. Urinary incontinence after vaginal delivery or cesarean section. The New England Journal of Medicine. 2003;348(10):900-7.
- 24. Whyte H, Hannah ME, Saigal S, Hannah WJ, Hewson S, Amankwah K, et al. Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. AJOG. 2004;191(3):864-71.
- 25. Wilson PD, Herbison RM, Herbison GP. Obstetric practice and the prevalence of urinary incontinence three months after delivery. BJOG. 1996;103(2):154-61.
- 26. Leijonhufvud A, Lundholm C, Cnattingius S, Granath F, Andolf E, Altman D. Risks of stress urinary incontinence and pelvic organ prolapse surgery in relation to mode of childbirth. AJOG. 2011;204(1):70 e1-7.
- 27. Blomquist JL, Muñoz A, Carroll M, Handa VL.Association of Delivery Mode With Pelvic Floor Disorders After Childbirth. JAMA. 2018 Dec 18;320(23):2438-2447.
- 28. Novellas S, Chassang M, Verger S, Bafghi A, Bongain A, Chevallier P. MR features of the levator ani muscle in the immediate postpartum following cesarean delivery. International Urogynecology Journal. 2010;21(5):563-8.
Toplam 28 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kadın Hastalıkları ve Doğum |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2021 |
| Gönderilme Tarihi | 7 Mayıs 2021 |
| Kabul Tarihi | 14 Ekim 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 18 Sayı: 4 |
