Urinary incontinence during pregnancy and in the postpartum period

Pregnancy and childbirth involve anatomical and physiological changes in the pelvic floor that can negatively affect the urinary-continence mechanism. Thus, in both periods, the rates of urinary incontinence increase notably, with stress urinary incontinence being the most common type. The pathophysiological mechanisms involved in urinary incontinence in pregnancy and postpartum are not fully understood. Stress urinary incontinence is more closely linked to urethral sphincter deficiency than to impaired urethral support, although both conditions have been noted during pregnancy and postpartum. The primary risk factors for pregnancy-related urinary incontinence are maternal age, body mass index and parity. Postpartum, urinary incontinence is mainly associated with urinary incontinence during pregnancy and vaginal delivery. Currently, the only option to prevent urinary incontinence in pregnancy and early postpartum is performing intense pelvic floor muscle training (PFMT) during pregnancy under supervision, although the effectiveness of PFMT for treating urinary incontinence during pregnancy and postpartum has yet to be clarified. Further research is needed to assess the effect of PFMT in incontinent women during pregnancy and postpartum, and to identify women who are most likely to benefit from this treatment.