Stress Urinary Incontinence And Vaginal Childbirth
Stress incontinence is an involuntary loss of urine upon physical exertion or sneezing or coughing. Parity is a known risk factor for stress incontinence. Women who have delivered many children have three times higher prevalence of stress incontinence. Recent evidence suggests that the mode of delivery has a significant impact. The necessity of surgical intervention for incontinence is three times higher for women who delivered vaginally, compared to women who gave birth exclusively via cesarean section.
Pelvic Organ Prolapse And Vaginal Childbirth
Pelvic organ prolapse is defined as the descent of the uterus and vaginal walls into the vaginal canal. Recent studies suggest that prolapse is more common among parous women versus nulliparous women. In addition, vaginal childbirth increases the risk of pelvic organ prolapse. A potential association between spontaneous laceration and prolapse is suggested by a recent study of vaginally parous women five to ten years after their delivery. Those who had experienced more than one spontaneous perineal laceration were more likely to have a prolapse. No increase in prolapse was seen in association with episiotomy. These studies raise the question of whether episiotomy may be preferable to spontaneous laceration with respect to prolapse risk and it is an important area for further research.
Anal Incontinence And Vaginal Childbirth
Direct trauma and laceration of the anal sphincter complicates 2-16% of vaginal deliveries. Injury to the anal sphincter, even with recognition and repair, contributes to the development of anal incontinence.