Urinary Incontinence after Caesarean Section in Hong Kong Chinese Women

Abstract

Objectives: To assess the prevalence of urinary incontinence in Chinese women after undergoing Caesarean section and its possible risk factors.
Methods: This prospective cohort study was conducted in the postnatal wards of Queen Elizabeth Hospital, a tertiary hospital in Hong Kong. All Chinese women, with no history of vaginal delivery, who delivered by Caesarean section in our unit from March 2007 to September 2010 were recruited. Respondents’ quality of life was assessed by the validated Chinese version of Urogenital Distress Inventory. The same questionnaire was used to assess the condition of the respondents 3 months after delivery.
Results: Among the 680 women recruited, 374 (55%) reported urinary incontinence during pregnancy. The frequency dropped to 7% (n=39) 3 months after delivery. Age, parity, mode of Caesarean section, and practice of pelvic floor exercises during pregnancy all affected the prevalence of urinary incontinence as well as stress incontinence during pregnancy. Age, pre-pregnant body mass index, and stress incontinence during pregnancy were associated with stress incontinence 3 months post-delivery.
Conclusion: About 90% of the women who complained of urinary incontinence during pregnancy noted resolution of their symptoms 3 months after delivery. Notably, persons aged ≥37 years, overweight before pregnancy, and having de-novo urinary incontinence during pregnancy were at risk of postpartum stress incontinence even after Caesarean section. Thus, elective Caesarean section may not be advisable solely as a means of preventing or reducing urinary incontinence.