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Şanlıurfa’da Postpartum Üriner İnkontinans Prevalansı ve Etkileyen Faktörler

Year 2022, Volume: 19 Issue: 2, 394 - 401, 28.08.2022
https://doi.org/10.35440/hutfd.1089728

Abstract

Amaç: Çalışma, Şanlıurfa’da postpartum üriner inkontinans prevalansı ve etkileyen faktörleri belirlemek amacıyla yapılmıştır.
Materyal ve Metod: Kesitsel tipte olan araştırmanın evrenini, Şanlıurfa merkez ilçelerinde Aile Sağlığı Merkezlerinden sağlık hizmeti alan bir yıl içinde doğum yapmış kadınlar oluşturmuştur. Örnek seçiminde küme örnekleme yöntemi kullanılmış ve çalışma toplam 300 kadın ile tamamlanmıştır. Verilerin değerlendirilmesinde, tanımlayıcı istatistiklerden yüzde, ortalama, ortanca ve standart sapma; tek değişkenli analizlerden Ki-kare ve Mann Whithney-U testi kullanılmıştır.
Bulgular: Kadınların %40.3’ünde postpartum üriner inkontinans (%26.3’ünde stres tip üriner inkontinans, %24.7’sinde sıkışma tip üriner inkontinans ve %11.7’sinde mikst tip üriner inkontinans) olduğu belirlenmiştir. Herhangi bir eğitim kademesini tamamlamamış, sadece okur yazar olan, sosyal güvencesi olmayan, yaş ortancası 28 (18-43)’den büyük olan, kendiliğinden düşük öyküsü bulunan, son doğumu 24 saatten daha uzun süren, gebelik sayısı ve normal vajinal doğum sayısı daha fazla olan, konstipasyon ve öksürük şikayeti bulunan kadınlarda postpartum üriner inkontinansın daha fazla olduğu saptanmıştır (p<0.05).
Sonuç: Çalışma sonuçlarına göre, kadınlarda postpartum üriner inkontinans düzeyinin yüksek olduğu, sosyo-demografik ve obstetrik olumsuzluklar ile abdominal basıncı artıran kronik rahatsızlıkların postpartum üriner inkontinansı artırdığı belirlenmiştir. Bu sonuçlar doğrultusunda; postpartum üriner inkontinans semptomları, alınabilecek önlemler ve tedavisine yönelik olarak kadınların sağlık personelleri tarafından bilgilendirilmesi, değerlendirilmesi, desteklenmesi için gerekli eğitim ve danışmanlıkların yapılması önerilmiştir.

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References

  • 1. Haylen BT, De Ridder D, Freeman RM, et al. An International Urogynecological Association/International Continence Society joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.
  • 2. Irwin DE, Kopp ZS, Agatep B, et al. Worldwide prevalence of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011;108:1132–9.
  • 3. Kocaöz S, Eroğlu K. Gebelik ve vajinal doğum sonrası dönemde stres üriner ınkontinansın önlenmesinde konservatif tedavi yöntemleri ve hemşirenin rolleri. Turkiye Klinikleri J Nurs Sci. 2009;1(2): 94-102.
  • 4. Kaplan S, Demirci N. Üriner İnkontinansta Konservatif Tedavi Metotları. Fırat Sağlık Hizmetleri Dergisi. 2010; 5 (13): 1-13.
  • 5. Siahkal SF, Iravani M, Mohaghegh Z, Sharifipour F, Zahedian M. Maternal, obstetrical and neonatal risk factors' impact on female urinary incontinence: a systematic review. Int Urogynecol J. 2020 Nov;31(11):2205-2224.
  • 6. Rogers RG, Leeman LL. Postpartum genitourinary changes. Urol Clin N Am. 2007;34(1):13–21.
  • 7. Raza-Khan F, Graziano S, Kenton K, Shott S, Brubaker L. Peripartum urinary incontinence in a racially diverse obstetrical population. Int Urogynecol J Pelvic Floor Dysfunct. 2006 Sep;17(5):525-30.
  • 8. Weidner AC, South MM, Sanders DB, Stinnett SS. Change in urethral sphincter neuromuscular function during pregnancy persists after delivery. Am J Obstet Gynecol. 2009;201(5):529.e521–6. 5.
  • 9. Pizzoferrato AC, Fauconnier A, Bader G, de Tayrac R, Fort J, Fritel X. Is prenatal urethral descent a risk factor for urinary incontinence during pregnancy and the postpartum period? Int Urogynecol J. 2016;27(7):1003–11.
  • 10. Gartland D, MacArthur C, Woolhouse H, McDonald E, Brown SJ. Frequency, severity and risk factors for urinary and faecal incontinence at 4 years postpartum: a prospective cohort. BJOG. 2016 Jun;123(7):1203-11.
  • 11. İnal C. G., Taşhan S.T., Gebelikte üriner inkontinans ve yaşam kalitesi üzerine etkisi. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 2020; 6(2): s.150-160.
  • 12. Diez-Itza I, Zubikarai M, Galan C, Ginto L, Saro J, Arrue M. Factors involved in the persistence of stress urinary incontinence from postpartum to 12 years after first delivery. Neurourol Urodyn. 2020 Aug;39(6):1849-1855.
  • 13. Nam JY, Park EC, Cho E. Does Urinary Incontinence and Mode of Delivery Affect Postpartum Depression? A Nationwide Population-Based Cohort Study in Korea. Int J Environ Res Public Health. 2021 Jan 8;18(2):437.
  • 14. TÜİK (2020), Doğum İstatistikleri, https://data.tuik.gov.tr/Kategori/GetKategori?p=Nufus-ve-Demografi-109 .
  • 15. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. Standardisation Sub-Committee of the International Continence Society. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003 Jan;61(1):37-49.
  • 16. Ege E, Akin B, Altuntuğ K, Benli S, Arioz A. Prevalence of urinary incontinence in the 12-month postpartum period and related risk factors in Turkey. Urol Int. 2008;80(4):355-61.
  • 17. Ege, E., Akin, B., Koçoǧlu, D., Ariöz, A. Postpartum Bir Yıllık Dönemde Üriner İnkontinans Sorunu Yaşayan Kadınlarda Yaşam Kalitesi, Hemşirelikte Araştırma Geliştirme Dergisi, 2007;9(2), 46-56.
  • 18. Sampselle CM, Harlow SD, Skurnick J, Brubaker L, Bondarenko I. Urinary incontinence predictors and life impact in ethnically diverse perimenopausal women. Obstet Gynecol. 2002 Dec;100(6):1230-8.
  • 19. Yip SK, Cardozo L. Psychological morbidity and female urinary incontinence. Best Pract Res Clin Obstet Gynaecol. 2007 Apr;21(2):321-9.
  • 20. Van Brummen HJ, Bruinse HW, van der Bom JG, Heintz AP, van der Vaart CH. How do the prevalences of urogenital symptoms change during pregnancy? Neurourol Urodyn. 2006;25(2):135-9.
  • 21. Rajavuori A, Repo JP, Häkkinen A, Palonen P, Multanen J, Aukee P. Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol X. 2021 Nov 8;13:100138.
  • 22. Özkan, S. A., Bilgiç, D., Beji N. K., Türkiye’de hemşirelik alanında üriner inkontinansla ilgili yapılan lisansüstü tezlerin incelenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2019;(2), 201-210.
  • 23. Pirinççi S., Aydın merkezde prepartum gebelerde üriner inkontinans sıklığı, postpartum değişimi ve postpartum üriner inkontinansta pelvik taban kas eğitiminin etkinliği: Tıpta Uzmanlık Tezi, Aydın: Adnan Menderes Üniversitesi, 2016.
  • 24. Kocaöz S, Eroğlu K, Sivaslıoğlu AA. Role of pelvic floor muscle exercises in the prevention of stress urinary incontinence during pregnancy and the postpartum period. Gynecol Obstet Invest. 2013;75(1):34-40.
  • 25. Zengin N. Kadınlarda İdrar Kaçırma Prevalansı ve Risk Faktörleri. Fırat Sağlık Hizmetleri Dergisi, 2010; 5(3): 45-60.
  • 26. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S. Vaginal delivery parameters and urinary incontinence: the Norwegian EPINCONT study. Am J Obstet Gynecol. 2003 Nov;189(5):1268-74.
  • 27. Siahkal SF, Iravani M, Mohaghegh Z, Sharifipour F, Zahedian M. Maternal, obstetrical and neonatal risk factors' impact on female urinary incontinence: a systematic review. Int Urogynecol J. 2020 Nov;31(11):2205-2224.
  • 28. Xie X, Chen Y, Khan A, Long T, Li S, Xie M. Risk Factors for Urinary Incontinence in Chinese Women: A Cross-sectional Survey. Female Pelvic Med Reconstr Surg. 2021 Jun 1;27(6):377-381.
  • 29. Beji NK, Ozbas A, Aslan E, Bilgic D, Erkan HA. Overview of the social impact of urinary incontinence with a focus on Turkish women. Urol Nurs. 2010 Nov-Dec;30(6):327-34; quiz 335.
  • 30. Handa, V., Brubaker, L., Eckler, K. E., Effect of pregnancy and childbirth on urinary incontinence and pelvic organ prolapse, UpToDate. Whaltam, MA: UpToDate. Jan 2022.
  • 31. Baykuş N., 18 yaş üzeri kadınlarda üriner inkontinansın görülme sıklığı ve etkileyen faktörler: Yüksek Lisans Tezi, İzmir: Şifa Üniversitesi Sağlık Bilimleri Enstitüsü, 2016.
  • 32. Carlile A, Davies I, Rigby A, Brocklehurst JC. Age changes in the human female urethra: a morphometric study. J Urol. 1988 Mar;139(3):532-5.
  • 33. Hage-Fransen MAH, Wiezer M, Otto A, Wieffer-Platvoet MS, Slotman MH, Nijhuis-van der Sanden MWG et al., Pregnancy- and obstetric-related risk factors for urinary incontinence, fecal incontinence, or pelvic organ prolapse later in life: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2021 Mar;100(3):373-382.
  • 34. Schytt E, Lindmark G, Waldenström U. Symptoms of stress incontinence 1 year after childbirth: prevalence and predictors in a national Swedish sample. Acta Obstet Gynecol Scand. 2004 Oct;83(10):928-36.
  • 35. Solans-Domènech M, Sánchez E, Espuña-Pons M; Pelvic Floor Research Group (Grup de Recerca del Sòl Pelvià; GRESP). Urinary and anal incontinence during pregnancy and postpartum: inciadence, severity, and risk factors. Obstet Gynecol. 2010 Mar;115(3):618-628.
  • 36. Kılıçlı, A, Koruk, F., Unforseen Health Problem in Female Seasonal Agricultural Workers: Urinary Incontinence. LIFE: International Journal of Health and Life Sciences, 2018; 4(1),37-53.
  • 37. Zhong R, Zeng L, Wang X, Wang Y. A retrospective study of risk factors for stress urinary incontinence 1 year after delivery in multiparous women. Int Urogynecol J. 2021 May 4,1-7.
  • 38. Kokabi R, Yazdanpanah D. Effects of delivery mode and sociodemographic factors on postpartum stress urinary incontinency in primipara women: A prospective cohort study. J Chin Med Assoc. 2017 Aug;80(8):498-502.

The Prevalence of Postpartum Urinary Incontinence in Sanliurfa and Affecting Factors

Year 2022, Volume: 19 Issue: 2, 394 - 401, 28.08.2022
https://doi.org/10.35440/hutfd.1089728

Abstract

Background: The aim of study was to determine the prevalence of postpartum urinary incontinence and the affecting factors in Şanlıurfa.
Materials and Methods: The study was conducted in cross-sectional type. The population of the study consisted of women who gave birth within a year and received health services from Family Health Centers in central districts of Sanlıurfa. Cluster sampling method was used for the selection of the sample and the study was completed with 300 women. For the analysis of the data, descriptive statistics of percentage, mean and standard deviation were used together with Chi-square as a univariate analysis and Man Whit-ney-U test.
Results: 40.3% of women had postpartum urinary incontinence (26.3% stress urinary incontinence, 24.7% urge urinary incontinence and 11.7% mixed urinary incontinence). Postpartum urinary incontinence was found to be more common among women who had not completed any educational level and were only literate with no social security, a median age more than 28, a history of miscarriage, a labor and birth process that lasted for more than 24 hours, a number of pregnancies, a complain of constipation and cough, and higher normal vaginal deliveries (p<0.05).
Conclusions: According to the results of the study, it was found that the postpartum urinary incontinence level was high in the women, and socio-demographic, obstetric problems and chronic diseases that incre-ase abdominal pressure led to higher rates of postpartum urinary incontinence. In line with these results, it is suggested to provide necessary training and counseling by health staff to inform, evaluate and sup-port women for postpartum urinary incontinence symptoms, possible precautions, and treatment.

References

  • 1. Haylen BT, De Ridder D, Freeman RM, et al. An International Urogynecological Association/International Continence Society joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.
  • 2. Irwin DE, Kopp ZS, Agatep B, et al. Worldwide prevalence of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011;108:1132–9.
  • 3. Kocaöz S, Eroğlu K. Gebelik ve vajinal doğum sonrası dönemde stres üriner ınkontinansın önlenmesinde konservatif tedavi yöntemleri ve hemşirenin rolleri. Turkiye Klinikleri J Nurs Sci. 2009;1(2): 94-102.
  • 4. Kaplan S, Demirci N. Üriner İnkontinansta Konservatif Tedavi Metotları. Fırat Sağlık Hizmetleri Dergisi. 2010; 5 (13): 1-13.
  • 5. Siahkal SF, Iravani M, Mohaghegh Z, Sharifipour F, Zahedian M. Maternal, obstetrical and neonatal risk factors' impact on female urinary incontinence: a systematic review. Int Urogynecol J. 2020 Nov;31(11):2205-2224.
  • 6. Rogers RG, Leeman LL. Postpartum genitourinary changes. Urol Clin N Am. 2007;34(1):13–21.
  • 7. Raza-Khan F, Graziano S, Kenton K, Shott S, Brubaker L. Peripartum urinary incontinence in a racially diverse obstetrical population. Int Urogynecol J Pelvic Floor Dysfunct. 2006 Sep;17(5):525-30.
  • 8. Weidner AC, South MM, Sanders DB, Stinnett SS. Change in urethral sphincter neuromuscular function during pregnancy persists after delivery. Am J Obstet Gynecol. 2009;201(5):529.e521–6. 5.
  • 9. Pizzoferrato AC, Fauconnier A, Bader G, de Tayrac R, Fort J, Fritel X. Is prenatal urethral descent a risk factor for urinary incontinence during pregnancy and the postpartum period? Int Urogynecol J. 2016;27(7):1003–11.
  • 10. Gartland D, MacArthur C, Woolhouse H, McDonald E, Brown SJ. Frequency, severity and risk factors for urinary and faecal incontinence at 4 years postpartum: a prospective cohort. BJOG. 2016 Jun;123(7):1203-11.
  • 11. İnal C. G., Taşhan S.T., Gebelikte üriner inkontinans ve yaşam kalitesi üzerine etkisi. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 2020; 6(2): s.150-160.
  • 12. Diez-Itza I, Zubikarai M, Galan C, Ginto L, Saro J, Arrue M. Factors involved in the persistence of stress urinary incontinence from postpartum to 12 years after first delivery. Neurourol Urodyn. 2020 Aug;39(6):1849-1855.
  • 13. Nam JY, Park EC, Cho E. Does Urinary Incontinence and Mode of Delivery Affect Postpartum Depression? A Nationwide Population-Based Cohort Study in Korea. Int J Environ Res Public Health. 2021 Jan 8;18(2):437.
  • 14. TÜİK (2020), Doğum İstatistikleri, https://data.tuik.gov.tr/Kategori/GetKategori?p=Nufus-ve-Demografi-109 .
  • 15. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. Standardisation Sub-Committee of the International Continence Society. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003 Jan;61(1):37-49.
  • 16. Ege E, Akin B, Altuntuğ K, Benli S, Arioz A. Prevalence of urinary incontinence in the 12-month postpartum period and related risk factors in Turkey. Urol Int. 2008;80(4):355-61.
  • 17. Ege, E., Akin, B., Koçoǧlu, D., Ariöz, A. Postpartum Bir Yıllık Dönemde Üriner İnkontinans Sorunu Yaşayan Kadınlarda Yaşam Kalitesi, Hemşirelikte Araştırma Geliştirme Dergisi, 2007;9(2), 46-56.
  • 18. Sampselle CM, Harlow SD, Skurnick J, Brubaker L, Bondarenko I. Urinary incontinence predictors and life impact in ethnically diverse perimenopausal women. Obstet Gynecol. 2002 Dec;100(6):1230-8.
  • 19. Yip SK, Cardozo L. Psychological morbidity and female urinary incontinence. Best Pract Res Clin Obstet Gynaecol. 2007 Apr;21(2):321-9.
  • 20. Van Brummen HJ, Bruinse HW, van der Bom JG, Heintz AP, van der Vaart CH. How do the prevalences of urogenital symptoms change during pregnancy? Neurourol Urodyn. 2006;25(2):135-9.
  • 21. Rajavuori A, Repo JP, Häkkinen A, Palonen P, Multanen J, Aukee P. Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol X. 2021 Nov 8;13:100138.
  • 22. Özkan, S. A., Bilgiç, D., Beji N. K., Türkiye’de hemşirelik alanında üriner inkontinansla ilgili yapılan lisansüstü tezlerin incelenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2019;(2), 201-210.
  • 23. Pirinççi S., Aydın merkezde prepartum gebelerde üriner inkontinans sıklığı, postpartum değişimi ve postpartum üriner inkontinansta pelvik taban kas eğitiminin etkinliği: Tıpta Uzmanlık Tezi, Aydın: Adnan Menderes Üniversitesi, 2016.
  • 24. Kocaöz S, Eroğlu K, Sivaslıoğlu AA. Role of pelvic floor muscle exercises in the prevention of stress urinary incontinence during pregnancy and the postpartum period. Gynecol Obstet Invest. 2013;75(1):34-40.
  • 25. Zengin N. Kadınlarda İdrar Kaçırma Prevalansı ve Risk Faktörleri. Fırat Sağlık Hizmetleri Dergisi, 2010; 5(3): 45-60.
  • 26. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S. Vaginal delivery parameters and urinary incontinence: the Norwegian EPINCONT study. Am J Obstet Gynecol. 2003 Nov;189(5):1268-74.
  • 27. Siahkal SF, Iravani M, Mohaghegh Z, Sharifipour F, Zahedian M. Maternal, obstetrical and neonatal risk factors' impact on female urinary incontinence: a systematic review. Int Urogynecol J. 2020 Nov;31(11):2205-2224.
  • 28. Xie X, Chen Y, Khan A, Long T, Li S, Xie M. Risk Factors for Urinary Incontinence in Chinese Women: A Cross-sectional Survey. Female Pelvic Med Reconstr Surg. 2021 Jun 1;27(6):377-381.
  • 29. Beji NK, Ozbas A, Aslan E, Bilgic D, Erkan HA. Overview of the social impact of urinary incontinence with a focus on Turkish women. Urol Nurs. 2010 Nov-Dec;30(6):327-34; quiz 335.
  • 30. Handa, V., Brubaker, L., Eckler, K. E., Effect of pregnancy and childbirth on urinary incontinence and pelvic organ prolapse, UpToDate. Whaltam, MA: UpToDate. Jan 2022.
  • 31. Baykuş N., 18 yaş üzeri kadınlarda üriner inkontinansın görülme sıklığı ve etkileyen faktörler: Yüksek Lisans Tezi, İzmir: Şifa Üniversitesi Sağlık Bilimleri Enstitüsü, 2016.
  • 32. Carlile A, Davies I, Rigby A, Brocklehurst JC. Age changes in the human female urethra: a morphometric study. J Urol. 1988 Mar;139(3):532-5.
  • 33. Hage-Fransen MAH, Wiezer M, Otto A, Wieffer-Platvoet MS, Slotman MH, Nijhuis-van der Sanden MWG et al., Pregnancy- and obstetric-related risk factors for urinary incontinence, fecal incontinence, or pelvic organ prolapse later in life: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2021 Mar;100(3):373-382.
  • 34. Schytt E, Lindmark G, Waldenström U. Symptoms of stress incontinence 1 year after childbirth: prevalence and predictors in a national Swedish sample. Acta Obstet Gynecol Scand. 2004 Oct;83(10):928-36.
  • 35. Solans-Domènech M, Sánchez E, Espuña-Pons M; Pelvic Floor Research Group (Grup de Recerca del Sòl Pelvià; GRESP). Urinary and anal incontinence during pregnancy and postpartum: inciadence, severity, and risk factors. Obstet Gynecol. 2010 Mar;115(3):618-628.
  • 36. Kılıçlı, A, Koruk, F., Unforseen Health Problem in Female Seasonal Agricultural Workers: Urinary Incontinence. LIFE: International Journal of Health and Life Sciences, 2018; 4(1),37-53.
  • 37. Zhong R, Zeng L, Wang X, Wang Y. A retrospective study of risk factors for stress urinary incontinence 1 year after delivery in multiparous women. Int Urogynecol J. 2021 May 4,1-7.
  • 38. Kokabi R, Yazdanpanah D. Effects of delivery mode and sociodemographic factors on postpartum stress urinary incontinency in primipara women: A prospective cohort study. J Chin Med Assoc. 2017 Aug;80(8):498-502.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Helin Kalır This is me 0000-0002-5369-3897

Fatma Koruk 0000-0003-2984-3776

Publication Date August 28, 2022
Submission Date March 18, 2022
Acceptance Date August 7, 2022
Published in Issue Year 2022 Volume: 19 Issue: 2

Cite

Vancouver Kalır H, Koruk F. Şanlıurfa’da Postpartum Üriner İnkontinans Prevalansı ve Etkileyen Faktörler. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(2):394-401.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty