Is cesarean section a real panacea to prevent pelvic organ disorders?

The aim of this study is to compare the pelvic floor muscle strength after vaginal delivery vs. after cesarean section.

Five groups of 50 cases each were designated as follows: nullipara (control group), spontaneous vaginal delivery (SVD), repeat SVD (SVD-R), cesarean section (CS), and repeat CS (CS-R). Perineometric measurements, stress urinary incontinence (SUI) symptoms, pelvic organ prolapse quantification examinations, and Incontinence-Specific Quality of Life Questionnaire (IQOL) were evaluated.

In all delivery groups, pelvic muscle strength was significantly lower than the control group (65.10 ± 15.69, 56.29 ± 17.39, 54.28 ± 20.08, 56.82 ± 17.62, and 57.92 ± 16.45 (cm H(2) ± SD) for the control, SVD, SVD-R, CS, and CS-R groups, respectively; p < 0.05). However, no significant difference was found among the delivery groups. There were significant differences in SUI symptoms between the control (2%) and SVD-R (26%) groups and between the SVD (10%) and SVD-R groups (p < 0.001 and p = 0.037, respectively). No statistically significant correlations between IQOL and perineometric measurements were noted (r = 0.097 and p = 0.598).

Pregnancy increases postpartum muscle weakness independent of the mode of delivery. Increased SUI symptoms are associated with vaginal delivery.