Review article

RISK FACTORS FOR DEVELOPMENT OF PELVIC FLOOR INJURIES AND URINARY INCONTINENCE IN WOMEN

Aleksandar Dijaković ; Klinika za ženske bolesti i porode Kliničkog bolničkog centra u Zagrebu, Petrova 13, Zagreb
Slavko Orešković ; Klinika za ženske bolesti i porode Kliničkog bolničkog centra u Zagrebu, Petrova 13, Zagreb
Marina Ivanišević ; Klinika za ženske bolesti i porode Kliničkog bolničkog centra u Zagrebu, Petrova 13, Zagreb
Josip Juras ; Klinika za ženske bolesti i porode Kliničkog bolničkog centra u Zagrebu, Petrova 13, Zagreb
Josip Đelmiš ; Klinika za ženske bolesti i porode Kliničkog bolničkog centra u Zagrebu, Petrova 13, Zagreb

Abstract

Pelvic organ prolaps and urinary incontinence are common conditions in more than 20% perimenopausal women. Urinary incontinence according to definition is any involuntary urinary loss.1 Pelvic organ prolapse is protrusion of the pelvic organs into or out of the vaginal canal.1 Stress, urgent and mixed urinary incontinence are the three most common forms of urinary incontinence. Many studies have shown an increased prevalence of urinary incontinence with advancing age. The severity of urinary incontinence also increases with age; this may be explained by the interplay of multiple factors during the aging proces, including increasing medical comorbidities, medications use, impaired mobility and menopause. Obesity is risk factor for urinary incontinence, and higher BMI (Body Mass Index) is associated with an increased severity of urinary incontinence. Most women develop urinary incontinence, especially stress urinary incontinence, and pelvic organ prolapse after vaginal childbirth. Vaginal birth can cause direct damage to the pelvic floor soft tissues. This effect is compounded by the long term pelvic floor muscle dysfunction that results from damage to the pelvic nerves at the time of delivery. Increasing parity and increasing number of vaginal deliveries are important risk factors for pelvic organ prolaps. Obstetrical pelvic floor injuries is most common connection to pelvic floor prolaps and urinary incontinence. Pelvic organ prolaps is more common among women with lower levels of educations. This may be due to socioeconomic status, nutritional status, or lifetime of work. Chronic increased intraabdominal pressure has been proposed as a risk factor for pelvic organ prolaps. Women with chronic obstructive lung disease or chronic constipation, or obese women will often develop pelvic organ prolaps and urinary incontinence. Women who have had cesarean section, when compared to nulliparous women, have higher incidence of urinary incontinence espesially urgent and mixed urinary incontinance. Low estrogen production after menopause results in atrophy of the urethral epithelium with subsequent atrophic urethritis and cystitis that can predispose to the development of both stress and urgent urinary incontinence. Congenital disorders of connective tissue as well as neurological conditions also have been associated with pelvic organ prolapse and urinary incontinence, especially in young women.

Keywords

pelvic organ prolaps; urinary incontinence; obstetrical injuries

Hrčak ID:

65968

URI

https://hrcak.srce.hr/65968

Publication date:

1.12.2009.

Article data in other languages: croatian

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