Postpartum Incontinence

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Abstract
From a questionnaire survey dealing with urinary incontinence during pregnancy and after childbirth 62 women were randomly selected. These women underwent simultaneous urethrocystometry including urethral profile measurement 7-14 days parturition. From the case history 2 groups of patients could be distinguished. One group consisted of women who experienced only occasionally urine leakage after delivery. Pressure recordings in these previous patients were normal; the urethral closure pressure was positive, also at cough provocations. The urethral length and pressure were similar to that found in continent females. The other group of patients reported stress incontinence of a more serious and permanent nature; the symptoms did not disappear after delivery. In all these women negative urethral closure pressures were recorded at cough provocations and simultaneously leakage of urine from the urethra was observed. The urethral length was shorter and urethral resting pressure lower than that recorded in the 1st group of patients. The reversible symptoms in the 1st group of women may be a consequence of the pressure exerted by the uterus upon the bladder at coughing combined with a hormonal relaxation of the urethral suspension. In the 2nd group, the enduring symptoms suggest irreversible damage to the urethra and its suspension system during pregnancy.

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