Diastasis recti abdominis after childbirth: Is it a predictor of stress urinary incontinence?

Pregnancy and childbirth are considered risk factors for the development of diastasis recti abdominis (DRA). This anatomical change could be on the basis of stress urinary incontinence (SUI). Aim of this study was to assess the relationship between the value of DRA and SUI, in order to understand, if a specific abdominal rehabilitation might be indicated.

All women with clinically and urodynamically proven SUI (group 1) 6 months after first childbirth, have been enrolled and compared with women without any symptoms of SUI (group 2). Exclusion criteria were age > 45 years, pelvic organ prolapse > II stage, previous abdominal surgery including cesarean section, BMI (Body Mass Index) > 30, previous weight loss > 10 kg, presence of abdominal hernia, and pathological connective tissue laxity. Physical examination and ultrasound measurement of DRA were performed. DRA in women with SUI were compared with DRA in continent women.

During the study period, 35 (48 %) incontinent women were included in group 1 and 38 (52 %) continent women were included in group 2. The two groups did not differ in any characteristics. No statistically significant differences in the mean value of DRA, 1.76 cm (±0.81 DS) in group 1 versus 1.69 (±0.79 DS) in group 2 (p value = 0.91), were found.

DRA is not a risk factor for SUI. Therefore, an intervention on the abdominal muscles during pelvic floor rehabilitation for SUI does not seem to be justified.