Urine Leakage Not Due to Childbirth
Study of Sisters: Blame Genes, Not Kids, for Later-Life Urinary Incontinence
Dec. 2, 2005 - Doctors think it's true. Patients think it's true. And
urogynecologist Gunhilde M. Buchsbaum, MD, thought vaginal childbirth put women
at risk of urinary incontinence.
Not any more. Buchsbaum, an associate professor at the University of
Rochester, N.Y., now thinks childbirth has nothing to do with whether a woman
suffers urinary incontinence after menopause.
And she has a good reason to think so. Buchsbaum's team studied pairs of
postmenopausal sisters. In each pair, one sister had at least one child by
vaginal delivery. The other never had a child. No matter how the researchers
looked at it, the results came out the same.
"In a group of sisters where half were childless and half had children,
we found no difference in urinary incontinence," Buchsbaum tells WebMD.
"There was no difference in type of incontinence, overall prevalence of
incontinence, or severity of incontinence."
The findings appear in the December issue of Obstetrics &
Sisters and Urinary Incontinence
It's very common for doctors to think that vaginal delivery puts a woman at
risk of urinary incontinence. In fact, a recent survey found that 62% of
urogynecologists would support a woman's decision to choose to have a C-section
to prevent it.
Yet studies on childbirth and urinary incontinence are divided. Some show a
risk, others fail to find one.
Buchsbaum's interest in the issue came when she was contacted by a nearby
"The mother superior said, 'I think we have a problem,'" she
As they reached the age of menopause, many of the nuns were suffering
urinary incontinence. Yet medical examination revealed the obvious: None of the
women had ever had a child.
Preliminary studies led Buchsbaum to suspect that childbirth is not a
woman's major lifetime risk factor for urinary incontinence. So she and her
colleagues designed the current study.
Sisters' Sisters and Urinary Incontinence
At first, the researchers looked at the convent sisters and the sisters'
married sisters. The study was later expanded to include other postmenopausal
sister pairs where one had had a child by vaginal delivery and the other never
The researchers looked at whether the women suffered urinary incontinence.
They looked at whether they suffered stress incontinence (involuntary urination
caused by activity such as coughing), urge incontinence (urination caused by
overactive bladder), or mixed incontinence. They looked at incontinence
severity. In every regard, the women who gave birth were no more likely to
suffer urinary incontinence than their childless sisters.
"Everyone says vaginal delivery causes incontinence, so we looked at
sisters sharing a genetic pool, to see what is the greatest risk factor --
having kids or coming from same family," Buchsbaum says. "Childbirth is
no risk factor -- none."
Genetic Risk for Urinary Incontinence?
While having a child wasn't a risk for urinary incontinence, having a sister
with the problem was a different story.