Abstract
Background
There are few studies of lower urinary tract symptoms (LUTS) in women with different modes of delivery after 42 days. It is doubtful whether the onset of LUTS is related to the decline of pelvic muscle function after delivery.
Methods
This was an observational study conducted at Peking University First Hospital from 2019 to 2022. A total of 2462 women were recruited and interviewed 42 days after delivery using questionnaires, and gynecological physical examinations and pelvic floor muscle screening were performed. A modified Chinese Bristol Female Lower Urinary Tract Symptoms questionnaire was administered. The participants were asked about the presence of individual LUTS and rated the level of bother caused by those symptoms. Descriptive statistics, χ2 tests, one-way ANOVA and multivariate logistic regressions were used for data analysis.
Results
The prevalence of any LUTS, storage symptoms, or voiding symptoms was 70.6%, 65.4%, and 23.0%, respectively. Nocturia was the most common symptom (35.4%), followed by frequency (25.6%), urgency (25.3%) and stress urinary incontinence (SUI; 20.8%). Nocturia and frequency were not frequently rated as bothersome (38.0%, 21.5%). Urinary incontinence (UI) was the most frequently reported as severely bothersome (SUI 15.6%, urge urinary incontinence (UUI) 15.3%). Vaginal delivery (VD) and forceps delivery (FD) were strong predictors of LUTS (P < 0.05). Compared with cesarean section (CS), VD, especially FD, was associated with lower surface electromyography (sEMG) activity, including resting baseline and contraction amplitude (P < 0.001).
Conclusions
More than half of women experienced LUTS 42 days after delivery. Nocturia, frequency, urgency, and SUI were the most prevalent LUTS. Straining and UI were most frequently reported as bothersome, while UI caused severe discomfort. VD, especially FD, was more likely to cause pelvic floor muscle or nerve damage and was the strongest predictor of storage LUTS.