Pelvic floor dysfunction 6 years post vaginal versus cesarean delivery

ABSTRACT OBJECTIVE: To estimate fecal, urinary and sexual symptoms 6 years after uncomplicated vaginal versus elective cesarean deliveries. METHODS: Patients who delivered 6 years (2000-2004) before this study were chosen at random from our hospital database. Singleton elective cesarean deliveries (eCS, cases) were compared to uncomplicated vaginal deliveries (uVD, controls). Validated questionnaires grading fecal, urinary incontinence and sexual dysfunction were completed by the patients. RESULTS: A total of 309 women with uVD and 208 with eCS returned postal questionnaires in 2008. Socio-demographic characteristics and fecal incontinence were similar between groups. After eCS, women reported significantly less urge urinary incontinence (aOR 0.55; 95%CI 0.34-0- 88) and stress incontinence (aOR 0.53; 95%CI 0.35-0-80) than after uVD. However, pain associated with urination (aOR 1.58; 95%CI 1.01-2.49) and sexual activity (aOR 0.40; 95%CI 0.19-0.84) was significantly more frequent after eCS than uVD. CONCLUSION: Six years postpartum, uVD is strongly associated with urinary incontinence, while eCS is associated with sexual and urination pains