Urethral Diameter at the Time of Birth and Its Implication on Urinary Incontinence

Abstract

Background: Throughout life, many women develop urinary incontinence (UI), and vaginal birth has been implicated as one of the causes of this pathology, once it may cause damages to the pelvic floor and to the continence mechanism. The aim was to compare urethral diameter between primiparous women after vaginal birth and women after elective cesarean section, without previous vaginal birth, correlating these measurements with factors related to pregnancy and childbirth and with presence of UI within 6 months of childbirth.

Methods: Urethral diameter was measured in the immediate postpartum period (up to 2 days) by transperineal ultrasound at the level of the bladder neck and mid urethra. The data were collected on pregnancy and birth. Six months after childbirth, the participants were assessed for the presence of UI.

Results: Of 151 women, 73 delivered vaginally (group 1) and 78 had a cesarean section (group 2). Urethral diameter at the level of the bladder neck was significantly smaller in group 2 (P ≤ 0.0001). There was no significant difference between the two groups in urethral diameter at the mid urethra (P = 0.505). Only urethral diameter at the mid urethra was inversely correlated with UI at 6 months (P = 0.014). There was a positive correlation between presence of UI during pregnancy and at 6 months after childbirth (r_s = 0.214, P = 0.016).

Conclusions: A significant difference was observed in the urethral diameter at the bladder neck according to the mode of birth. A positive correlation was also found between presence of UI during pregnancy and at 6 months postpartum.

J Clin Gynecol Obstet. 2020;9(4):102-107
doi: https://doi.org/10.14740/jcgo705