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Korean Journal of Obstetrics & Gynecology 2007;50(4):638-644.
Published online April 1, 2007.
The effects of the number of normal vaginal deliveries to the function of low urogenital system.
Yong Ju Mon, Hee Sun Lim, Jae Eun Jung, Hyun Hee Cho, Mee Ran Kim, Yong Ok Lew, Eun Jung Kim, Jang Heub Kim, Jin Hong Kim
1Catholic University Medical College, St. Mary's Hospital, Department of Obstetrics and Gynecology, Korea. drrabbit@catholic.ac.kr
2Wonkwang University Sanbon medical center, Department of Obstetrics and Gynecology, GyeongGi, Korea.
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 AND 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.
Key Words: Vaginal delivery, Urogenital function, Fecal incontinence, Urinary incontinence


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