Effect of delivery and episiotomy on the emergence of urinary incontinence in women: review of literature.

EFFECT OF DELIVERY AND EPISIOTOMY ON THE EMERGENCE OF URINARY INCONTINENCE IN WOMEN: REVIEW OF LITERATURE. Acta Clin Croat. 2016 12;55(4):615-24 Authors: Živković K, Živković N, Župić T, Hodžić D, Mandić V, Orešković S Abstract Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine medio-lateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased. The role of episiotomy in development of pelvic floor dysfunction remains quite unclear. Due to the mentioned reason, restricted episiotomy approach should be accepted. The origin of stress incontinence during pregnancy is controversial and not definitely scientifically proven. Pregnancy per se and older age at first delivery may have impact on the onset of pelvic floor dysfunction. Urinary incontinence in pregnancy increases the risk of later urinary incontinence, both postpartum and later in life. Vaginal delivery is just one of the potential risk factors for development of urinar...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research

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CONCLUSIONS: There is insufficient evidence to make general conclusions about the effectiveness and safety of laxatives for preventing postpartum constipation. The evidence in this review was assessed as low to very low-certainty evidence, with downgrading decisions based on limitations in study design, indirectness and imprecision. We did not identify any trials assessing educational or behavioural interventions. We identified four trials that examined laxatives versus placebo, and one that examined laxatives versus laxatives plus stool bulking agents. Further, rigorous trials are needed to assess the effectiveness and sa...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSION: The most frequent pelvic floor dysfunctions (PFD) after birth were perineal pain, constipation, flatus incontinence, dyspareunia and IU respectively. It was seen that the symptomatic PFD was very common in the postpartum period. The results of the study emphasized the importance of lifestyle changes, avoiding perineal trauma during childbirth, and effective pelvic floor exercises in preventing PFD in pregnancy and postpartum. IMPACT STATEMENT: Nurses should acknowledge the importance of PFD after birth and identify the problems early period. Our study emphasizes size of the problem and improvement for PFD. ...
Source: Contemporary Nurse - Category: Nursing Tags: Contemp Nurse Source Type: research
ConclusionKnowing which factors are associated with the manifestation of SUI and dyspareunia in women after delivery is useful for identifying susceptible or "at risk" patients. These variables should be included in the clinical history of every pregnant woman.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionWarm compresses applied during the second stage of labor increase the incidence of intact perineum and lower the risk of episiotomy and severe perineal trauma.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionsVBAC does not confer an increased risk of OASI after a first delivery by caesarean section when compared with nulliparous women. The rate of successful VBAC may be contributory and suggests that the risk conferred by VBAC may be unit-specific. Unit and national-level audit is necessary to investigate this risk further.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
ConclusionsPrenatal EMG may be used to predict the impact of right-sided mediolateral episiotomy on EAS and perhaps also function following delivery.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
ConclusionSome combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence six months postpartum in a synergetic way.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Original Research Article Source Type: research
ConclusionSome combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence 6 months postpartum in a synergetic way.This article is protected by copyright. All rights reserved.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Original Research Article Source Type: research
Conclusion Endo-anal sonography might be a good screening tool for early detection of postpartum anal sphincter damages. However, further prospective cost benefit studies should be performed to propose it as a standard of care.
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
CONCLUSIONS: In women where no instrumental delivery is intended, selective episiotomy policies result in fewer women with severe perineal/vaginal trauma. Other findings, both in the short or long term, provide no clear evidence that selective episiotomy policies results in harm to mother or baby.The review thus demonstrates that believing that routine episiotomy reduces perineal/vaginal trauma is not justified by current evidence. Further research in women where instrumental delivery is intended may help clarify if routine episiotomy is useful in this particular group. These trials should use better, standardised outcome ...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
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