Incontinence Three Times More Likely After Vaginal Delivery

(Evanston, IL - November 15, 2004)  Many women are concerned about whether their bodies will "get back to normal" after childbirth and may wonder which delivery mode is "best" - vaginal or cesarean. While Cesarean deliveries involve major surgery and have greater potential for maternal complications, new research has shed light on one benefit of cesarean delivery over vaginal birth. In an internationally recognized, award-winning study, Roger Goldberg, MD, MPH, director of Urogynecology Research at the Evanston Continence Center, has found the rate of stress urinary incontinence (SUI) was three times higher in women after vaginal childbirth compared to cesarean. In fact, a woman's mode of delivery impacts her risk of SUI more profoundly than any other factor, including age, body mass index, or the number of childbirths.

The study, entitled Delivery Mode is the Main Determinant of Stress Urinary Incontinence After Childbirth: Analysis of 288 Identical Twins, won Dr. Goldberg the top research award from the two largest professional groups in the world that study continence issues - the International Continence Society and the International Urogynecology Association. Their first joint meeting was held August 23-27, 2004, in Paris. The organizations cited the study as a landmark in women's health research for providing new insights into a controversial issue.

The study involved an extensive survey of 144 identical twin sister pairs (288 women) at the world's largest annual gathering of twins in Twinsburg, Ohio, in order to determine the main environmental risk factors associated with stress urinary incontinence. The average age of respondents was 47 years and 54 percent of the women had symptoms of stress incontinence.

"Unlike previous studies," Goldberg says, "this allows us to finally conclude that mode of delivery has a fundamental impact on a woman's risk of incontinence. It is clear that a woman's decision between vaginal and cesarean birth may have important physical repercussions." Despite the finding, he cautions, "Cesarean delivery by choice remains a complex issue relating to many physical and psychological factors, which should be carefully discussed between a woman and her doctor."  However, the Twin Sisters Study does provide remarkable new insight into the effects of childbirth on a woman's body."

"This study of identical twin sisters is revolutionary because it provides the strongest evidence yet on the relationship between a woman's obstetrical choices and her risk of developing incontinence," says Peter K. Sand, MD, secretary/treasurer of the International Urogynecology Association. "Previous studies have not been able to determine whether stress urinary incontinence was caused by 'nature' or 'nurture' (genetic or environmental factors), but the Twin Sisters Study enables us to draw powerful conclusions because it controls for genetic risk factors in order to understand environmental risk factors."

For more information on SUI, click here.

Created: 11/15/2004  -  Donnica Moore, M.D.