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Does visceral peritoneal closure affect post-cesarean urinary symptoms? A randomized clinical trial
Ahmed Y Shahin1, Diaa A Hameed
1Department of Obstetrics and Gynecology, Women's Health Centre, Assiut University, Assiut, Egypt. Ahmed.Shahin@web.de
International Urogynecology Journal
|September 23, 2009
Summary
Cesarean visceral peritoneal closure may increase postpartum urinary issues like incontinence and frequency. However, these symptoms typically resolve naturally within six months without intervention.
Area of Science:
- Obstetrics and Gynecology
- Urogynecology
Background:
- Cesarean sections are common surgical procedures.
- Postpartum urinary complaints can affect women's quality of life.
Purpose of the Study:
- To investigate the impact of visceral peritoneal closure during cesarean sections on postpartum urinary complaints.
- To test the hypothesis that upward bladder traction from visceral peritoneal closure affects urinary function.
Main Methods:
- Prospective randomized study of 620 women undergoing non-emergency cesarean sections.
- Two groups: visceral peritoneal closure (n=310) and non-closure (n=310).
- Assessed urinary complaints using the UDI-6 questionnaire and perineal ultrasound findings pre- and post-surgery.
Main Results:
- Visceral peritoneal closure group showed increased posterior urethrovesical and alpha angles, and greater urethral descent 48 hours postpartum.
- Higher incidence of urinary frequency, urge, and stress incontinence reported at 8 weeks postpartum in the closure group.
- Symptoms resolved almost completely by 6 months postpartum in both groups.
Conclusions:
- Cesarean sections with visceral peritoneal closure are associated with temporary postpartum urinary frequency and incontinence.
- These urinary symptoms are transient and typically resolve spontaneously within 6 months.
- Visceral peritoneal non-closure may be preferable to avoid short-term postpartum urinary dysfunction.
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