Urine Leakage Not Due to Childbirth
Study of Sisters: Blame Genes, Not Kids, for Later-Life Urinary Incontinence
WebMD News Archive
Childbirth Still a Suspect in Earlier-Life Incontinence
Buchsbaum's study finds no lifetime risk of urinary incontinence.
She is quick to point out that it does not say anything about whether vaginal
delivery brings on urinary incontinence sooner than it might otherwise
The Buchsbaum study is important, says Neeraj Kohli, MD, MBA, director of
urogynecology at Brigham and Women's Hospital and assistant professor at
Harvard Medical School, Boston. But Kohli says that vaginal childbirth does
appear linked to earlier onset of urinary incontinence.
"I see patients who are 40, who had their last delivery five years ago,
and they have urinary incontinence and their sisters don't have it," Kohli
tells WebMD. "As patients get older, vaginal delivery is less of a
causative issue. But in the younger population, vaginal deliver might be more
of a cause of pelvic-floor dysfunction -- including urinary
Kohli agrees with Galloway that different women have different problems with
vaginal delivery. And Kohli, Galloway, and Buchsbaum all agree that pregnant
women considering having a C-section in order to avoid urinary incontinence
should have a long talk with their doctor.
"I make recommendations specific to individual patients," Kohli
says. "If someone had incontinence or pelvic prolapse after her first
delivery, I might recommend C-section for her next one, because every
subsequent delivery causes further trauma. If I have a small woman with a big
baby, we would probably recommend C-section also. But at the end of the day, if
a patient says to her doctor, 'I want a primary elective C-section,' there
should be an extended discussion."
Galloway offers advice for how women can know whether their pelvic floor is
well suited to withstand the rigors of vaginal delivery.
"The nerves and muscles that enervate the feet are adjacent to those
responsible for the pelvic floor," Galloway says. "If you were trying
to distinguish whether you are at risk or not, look and see how complete is the
form and function of your feet and toes. Those with the best, most versatile
feet -- who can spread their toes like fingers -- are more likely to have
better function in the pelvic floor."