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Changes in Morphology of the Urethral Rhabdosphincter Postpartum
Meagan S Cramer, Emily R Boniface1, Amanda Holland1
1Department of OB/GYN, Oregon Health & Science University, Portland, OR.
Female Pelvic Medicine & Reconstructive Surgery
|February 23, 2021
Summary
Pregnancy significantly reduces urethral sphincter size, potentially impacting urinary symptoms. Fetal weight after vaginal birth correlates with this decrease, suggesting long-term pelvic floor implications.
Area of Science:
- Urogynecology
- Pelvic Floor Imaging
- Pregnancy Complications
Background:
- Pregnancy and childbirth can affect pelvic floor structures.
- Urethral rhabdosphincter integrity is crucial for urinary continence.
Purpose of the Study:
- To assess the impact of pregnancy on urethral rhabdosphincter cross-sectional area (CSA).
- To investigate the association between CSA changes and urinary symptoms.
Main Methods:
- Longitudinal study of nulliparous women from pre-pregnancy to 6 months postpartum.
- Magnetic resonance imaging (MRI) used to measure urethral rhabdosphincter CSA.
- Symptom and quality of life questionnaires assessed urinary distress.
Main Results:
- Median urethral rhabdosphincter CSA significantly decreased post-pregnancy (0.05 cm²).
- Urinary Distress Inventory scores increased postpartum, but without significant correlation to CSA change.
- Increased fetal weight correlated with decreased CSA after vaginal birth.
Conclusions:
- Pregnancy leads to a reduction in urethral rhabdosphincter CSA.
- While not directly correlated in this cohort, CSA decrease and urinary symptoms warrant attention.
- Fetal weight in vaginal births may influence postpartum sphincter size, with potential long-term consequences.
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