Acta clinica Croatica, Vol. 55. No. 4., 2016.
Pregledni rad
https://doi.org/10.20471/acc.2016.55.04.12
Effect of delivery and episiotomy on the emergence of urinary incontinence in women: review of literature
Krešimir Živković
; 1University of Zagreb, School of Medicine, Zagreb, Croatia; Clinical Department of Gynecology and Obstetrics, Sveti Duh University Hospital, Zagreb, Croatia
Nikica Živković
; Šibenik General Hospital, Department of Gynecology and Obstetrics, Šibenik, Croatia
Tomislav Župić
; University of Zagreb, School of Medicine, Zagreb, Croatia; Zagreb University Hospital Center, Zagreb, Croatia
Damir Hodžić
; University of Zagreb, Zagreb, Croatia; Merkur University Hospital, Clinical Department of Gynecology and Obstetrics, Zagreb, Croatia
Vjekoslav Mandić
; Mostar University Hospital, Department of Gynecology and Obstetrics, Mostar, Bosnia and Herzegovina
Slavko Orešković
; University of Zagreb, School of Medicine, Zagreb, Croatia; Zagreb University Hospital Center, Zagreb, Croatia
Sažetak
Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed mediolaterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine mediolateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased. The role of episiotomy in development of pelvic floor dysfunction remains quite unclear. Due to the mentioned reason, restricted episiotomy approach should be accepted. The origin of stress incontinence during pregnancy is controversial and not definitely scientifically proven. Pregnancy per se and older age at first delivery may have impact on the onset of pelvic floor dysfunction. Urinary incontinence in pregnancy increases the risk of later urinary incontinence, both postpartum and later in life. Vaginal delivery is just one of the potential risk factors for development of urinary incontinence. Mechanical pressure by fetus on the pelvic floor structures, limited denervation of the pelvic floor and soft tissue damage during delivery are some of explanations for the onset of stress urinary incontinence. On the other hand, cesarean delivery might not be protective against emergence of urinary incontinence. Further research in this field is needed.
Ključne riječi
Urinary incontinence; Pelvic floor disorders; Pregnancy; Episiotomy; Childbirth
Hrčak ID:
177963
URI
Datum izdavanja:
15.12.2016.
Posjeta: 3.545 *