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Urinary and anal incontinence after vacuum delivery
Ursula M Peschers1, Abdul H Sultan, Katharina Jundt
1Department of Obstetrics and Gynecology, Maistrasse, Ludwig-Maximilians Universitaet, Munich, Germany. ursula.peschers@fk-i.med.uni-meunchen.de
Summary
Vacuum delivery causes more anal sphincter defects, but pelvic floor function is similar to spontaneous vaginal delivery. Incontinence symptoms are common after both delivery types.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
Background:
- Urinary and fecal incontinence are common postpartum complications.
- Anal sphincter defects can occur after vaginal delivery, potentially leading to incontinence.
Purpose of the Study:
- To compare urinary and fecal incontinence symptoms and occult anal sphincter defects in women after vacuum versus spontaneous vaginal delivery.
Main Methods:
- A case-control study compared 50 primiparous women who underwent vacuum extraction with 50 who had spontaneous vaginal delivery.
- Incontinence symptoms, pelvic floor muscle strength, and anal sphincter defects (via endoanal ultrasound) were assessed 6-24 weeks postpartum.
Main Results:
- No significant difference in new anal or urinary incontinence symptoms between vacuum and spontaneous delivery groups.
- Sonographic anal sphincter defects were more frequent after vacuum delivery (27.5%) compared to spontaneous delivery (10%) (P<0.05).
Conclusions:
- While vacuum delivery is associated with a higher rate of sonographic sphincter defects, it does not appear to cause greater harm to overall pelvic floor function compared to spontaneous vaginal delivery.
- Incontinence symptoms are prevalent following both vacuum and spontaneous vaginal deliveries.