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KMID : 0358420070500040638
Korean Journal of Obstetrics and Gynecology
2007 Volume.50 No. 4 p.638 ~ p.644
The effects of the number of normal vaginal deliveries to the function of Low urogenital system
Mon Yong-Ju

Lim Hee-Sun
Jung Jae-Eun
Cho Hyun-Hee
Kim Mee-Ran
Lew Young-Ok
Kim Eun-Jung
Kim Jang-Heub
Kim Jin-Hong
Abstract
Objective: The purpose of this study was to evaluate if the number of normal vaginal deliveries influences lower urogenital system function and the incidence of incontinence.

Materials & Methods: The POP-Q (Pelvic Organ Prolapse Quantitation) examination was performed in 217 premenopausal women who visited our hospital for routine check up. They were asked to fill in the Bristol female lower urinary tract symptom (BFLUTS) and self-report questionnaire for fecal incontinence and constipation assessment questionnaires. Exclusion criteria included patients with a history of pelvic surgery, BMI >25, chronic lung disease, cardiovascular disease, colon disease or smoking.

Results: There was a significant difference between the vaginal delivery group and none vaginal delivery group in the point Aa, Ba, Ap, Bp and Tvl in POP-Q (P<0.05). The patients were classified into four groups (0, 1, 2,above 3) according to the number of vaginal deliveries, and the incidences of fecal incontinence were 4%, 29%, 32%, 26% in each group, respectively. The incidence of fecal incontinence was significantly lower (P<0.05) in those who did not deliver vaginally, while no difference was observed in the number of vaginal deliveries. The BFLUTS-IS (incontinence symptom) score was higher in the patients with higher number of vaginal deliveries (P<0.05). There were also more patients with sexual dysfunction as was shown by the BFLUTS-sex questionnaire (P<0.05) in those patients with higher number of vaginal deliveries.

Conclusion: We observed that the number of vaginal delivery is significantly associated with the incidence of fecal and urinary incontinence, and also that it was a major cause of disorders of the pelvic floor and sexual dysfunction.
KEYWORD
Vaginal delivery, Urogenital function, Fecal incontinence, Urinary incontinence
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