Influence of vaginal birth on lumbopelvic muscle mechanical properties on urinary incontinence

Abstract

Objective To identify differences in the muscle mechanical properties of the pelvic floor (PF) and lumbar paravertebral (LP) muscles between young nulliparous and uni/multiparous women. Secondarily, specific behaviors, depending on the presence or absence or urinary incontinence (UI), were also researched. Design Case–control study. Setting Higher education institution. Participants One hundred young women participated, divided into two groups depending on whether they had vaginal birth (nulliparous or uni/multiparous). Each group included women with and without UI. Main measures A muscle mechanical properties (tone, stiffness, decrement—inverse of elasticity—, and viscoelastic properties: relaxation and creep) assessment of the PF and LP muscles were performed with a hand-held tonometer. Results Tone and stiffness of both sides of the PF presented group by UI interaction ( p < 0.05), with uni/multiparous women with UI showing higher tone and stiffness compared to multiparous women without UI. In LP muscles, uni/multiparous women showed greater tone and stiffness on the right and left sides [−2.57 Hz (95% confidence interval −4.42,−0.72) and −79.74 N/m (−143.52,−15.97); −2.20 Hz (−3.82,−0.58) and −81.30 N/m (−140.66-,21.95), respectively], as well as a decrease in viscoelastic properties compared to nulliparous women [relaxation: 2.88 ms (0.31,5.44); creep: 0.15 (0.01,0.30); relaxation: 2.69 ms (0.13,5.25); creep: 0.14 (0,0.28), respectively]. Conclusions Vaginal birth and UI have a differential influence on the muscle mechanical properties of the PF and LP muscles. The determination of muscle mechanical properties by externally applied hand-held tonometry improves the knowledge of the lumbopelvic status, with applicability in clinical and research fields.