Severity and impact of accidental bowel leakage two decades after no, one, or two sphincter injuries.

Background: Information about the long-term severity and subjective impact of anal incontinence in women after 1 or 2 consecutive obstetrical anal sphincter injuries is still scarce and contradictory.

Objective: This study aimed to describe the severity and impact of anal incontinence among women with 2 previous deliveries 2 decades after birth and to analyze the relative effect of 1 vs 2 obstetrical anal sphincter injuries in comparison with no obstetrical anal sphincter injuries and the possible influence of obstetrical anal sphincter injury on other pelvic floor disorders.

Study Design: We linked prospectively registered data in the Swedish Medical Birth Register with information from a postal and web-based questionnaire in 2015.

The influence of age and health status for outcomes after mid-urethral sling surgery-a nationwide register study.

Introduction And Hypothesis: The efficacy of mid-urethral sling (MUS) surgery in older women and women with a significant disease burden is limited. We aimed to determine the influence of chronological age and physical status (assessed by the American Society of Anesthesiologists Physical Status, ASA) classification on outcomes.

Methods: Cure rate, change in frequency of lower urinary tract symptoms, satisfaction, impact, and adverse events after MUS surgery were assessed in 5200 women aged 55-94 years with MUS surgery (2010-2017).

The influence of pregnancy, parity, and mode of delivery on urinary incontinence and prolapse surgery-a national register study.

Background: The long-term effects of vaginal delivery, parity, and pregnancy on the pelvic floor remain uncertain and controversial issues. In comparison with studies using self-reported symptoms, surgical register data may offer a more valid means for evaluating the relative influence of these risk factors.

Objective: This study used data from 3 high-quality nationwide registers, namely the Swedish National Quality Register of Gynecological Surgery, the Swedish Medical Birth Register, and the Total Population Register, to evaluate the contribution of vaginal and cesarean delivery, parity, and factors not related to childbirth to the long-term risk for reconstructive urogenital surgery.

Fecal incontinence in nonpregnant nulliparous women aged 25 to 64 years-a randomly selected national cohort prevalence study.

Background: The extent to which fecal incontinence is associated with obstetrical history or pelvic floor injuries is still a controversial and unresolved issue. One crucial first step toward answering this question is the need to study fecal incontinence in nonpregnant, nulliparous women.

Objective: The aim of this study was to present detailed, descriptive measures of the accidental leakage of liquid or solid stool and gas in a randomly selected, large national cohort of nonpregnant, nulliparous women aged 25 to 64 years.

Temporal trends in obstetric anal sphincter injury from the first vaginal delivery in Austria, Canada, Norway, and Sweden.

Introduction: Obstetric anal sphincter injuries (OASI) are severe complications that can cause considerable short- and long-term morbidity. Austria, Canada, Norway, and Sweden have similar socio-economic characteristics, and all four countries have access to national birth registers. In this study, we hypothesized that the incidence of OASI should be very similar for different obstetric scenarios in these four countries.

Symptoms of fecal incontinence two decades after no, one, or two obstetrical anal sphincter injuries.

Background: The long-term effects of 1 or 2 consecutive obstetrical anal sphincter injuries on bowel continence are still inadequately investigated, and published results remain contradictory.

Objective: This study aimed to present detailed descriptive measures of the current bowel incontinence 20 years after the first birth in women who had 2 vaginal deliveries with and without sphincter injuries.

Study Design: Birth register data were used prospectively and linked to information from a questionnaire survey about current symptoms.

Childhood nocturnal enuresis-a marker for pelvic floor disorders and urinary tract symptoms in women?

Introduction And Hypothesis: A systematic survey on the association between childhood nocturnal enuresis (CNE) and adult pelvic floor disorders (PFDs) has not been presented previously. The aim was to describe the prevalence of PFDs and lower urinary tract symptoms in nulliparous women, with or without a history of CNE, at the age of ≥ 5 years.

Methods: This national survey of urinary (UI) and fecal incontinence (FI) and symptoms of pelvic organ prolapse (sPOP) was a random sample of 20,000 nulliparous women aged 25-64 years conducted in 2014.

Symptomatic pelvic organ prolapse in middle-aged women: a national matched cohort study on the influence of childbirth.

Background: The relative impact of age, pregnancy, and vaginal delivery on symptomatic pelvic organ prolapse is still an unresolved issue that involves the controversial question about the protective effect of cesarean section.

Objective: The purpose of this study was to compare the age-related prevalence of symptomatic genital prolapse in nulliparous, vaginal- and cesarean-delivered women aged 40-64 years.

Study Design: This Swedish, nationwide matched cohort study involved 14,335 women.

The effect of childbirth on urinary incontinence: a matched cohort study in women aged 40-64 years.

Background: The relative impact of age, pregnancy and vaginal delivery on urinary incontinence is still an unresolved issue that involves the controversial question about the protective effect of cesarean delivery.

Objective: The purpose of this study was to estimate and compare the effect size of 1 pregnancy, 1 vaginal delivery, and the derived protective effect of cesarean delivery for different aspects of urinary incontinence in women 40-64 years old, all 20 years after birth.

Study Design: This Swedish nationwide matched cohort study involved 14,335 women.

Breaking news in the prediction of pelvic floor disorders.

Urinary incontinence (UI) and fecal incontinence (FI) together with pelvic organ prolapse (POP) constitute a huge global health problem affecting millions of women throughout the world. These pelvic floor disorders (PFDs) can have a negative influence on a woman's well-being, quality of life, and sexual function and prevent many women from participating in recreational and sporting activities. The global costs of PFDs to health care systems and society are enormous and approximately one in five women will undergo surgery for genital prolapse or UI by the age of 85 years.

The symptom of vaginal bulging in nulliparous women aged 25-64 years: a national cohort study.

Introduction And Hypothesis: Vaginal bulging is considered the key symptom for genital organ prolapse. The aim was to investigate the age-related prevalence and frequency of symptomatic pelvic organ prolapse (sPOP) and other pelvic floor symptoms in nonpregnant nullipara aged 25-64 years.

Methods: This national postal and web-based questionnaire survey was conducted in 2014 and included four independent random samples of women aged 25-34, 35-44, 45-54, and 55-64 years.

Predicting risk of pelvic floor disorders 12 and 20 years after delivery.

Background: Little progress has been made in the prevention of pelvic floor disorders, despite their significant health and economic impact. The identification of women who are at risk remains a key element in targeting prevention and planning health resource allocation strategies. Although events around the time of childbirth are recognized clinically as important predictors, it is difficult to counsel women and to intervene around the time of childbirth because of an inability to convey a patient's risk accurately in the presence of multiple risk factors and the long time lapse, which is often decades, between obstetric events and the onset of pelvic floor disorders later in life.

Prevalence and predictors of overactive bladder in nonpregnant nulliparous women below 65 years of age.

Introduction And Hypothesis: The aetiology of the overactive bladder (OAB) symptom complex is still poorly understood. In order to obtain further insight, the prevalence and predictors of the symptoms included in OAB, that is urgency, urgency incontinence (UUI), frequency and nocturia, were investigated in a sample of nonpregnant nulliparous women.

Methods: A national, postal and web-based survey of OAB symptoms was conducted in women aged 25-64 years (n = 9,197).

Consensus Statement of the European Urology Association and the European Urogynaecological Association on the Use of Implanted Materials for Treating Pelvic Organ Prolapse and Stress Urinary Incontinence.

Context: Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae. Implantable materials have been adopted for the treatment of female and male stress urinary incontinence (SUI) and female pelvic organ prolapse (POP).

Objective: A consensus review of existing data based on published meta-analyses and reviews.

Urinary incontinence in nulliparous women aged 25-64 years: a national survey.

Background: A systematic survey of pelvic floor disorders in nulliparous women has not been presented previously.

Objective: The purpose of this study was to determine the prevalence of urinary incontinence parameters in a large cohort of nonpregnant, nulliparous women, and thereby construct a reference group for comparisons with parous women.

Study Design: This postal and World Wide Web-based questionnaire survey was conducted in 2014.

Long-term effects of vacuum extraction on pelvic floor function: a cohort study in primipara.

Introduction And Hypothesis: We describe the prevalence of symptomatic pelvic organ prolapse (sPOP), urinary incontinence (UI), fecal incontinence (FI) and obstetric anal sphincter injury (OASI) 20 years after one vacuum extraction (VE) delivery compared with one spontaneous vaginal delivery (SVD) or one acute caesarean section (ACS).

Method: We performed a register-based national cohort study of primipara who delivered between 1985 and 1988 and had no further deliveries. Medical Birth Register data were linked to data from postal questionnaires distributed 20 years after the birth (response rate 65.

Clustering of pelvic floor disorders 20 years after one vaginal or one cesarean birth.

Introduction And Hypothesis: The objective was to assess the prevalence and risk factors for co-occurring pelvic floor disorders (PFDs): urinary incontinence (UI), symptomatic pelvic organ prolapse (sPOP), and fecal incontinence (FI), 20 years after one vaginal (VD) or one cesarean (CS) delivery.

Methods: We carried out a registry-based national cohort study of primiparae who delivered during the period 1985-1988 and had no further deliveries. Medical Birth Registry data were linked to data from postal questionnaires distributed 20 years post-partum (response rate 65.

Faecal incontinence 20 years after one birth: a comparison between vaginal delivery and caesarean section.

Introduction And Hypothesis: The aetiology of bowel incontinence in middle-aged women is multifactorial and the contribution of birth-related factors later in life is still poorly defined. The aim was to assess prevalence, risk factors and severity of faecal (FI, defined as the involuntary loss of faeces-solid or liquid) and anal incontinence (AI, includes FI as well as the involuntary loss of flatus) 20 years after one vaginal (VD) or one caesarean section (CS).

Methods: This was a registry-based national cohort study of primiparae giving birth in 1985-1988 and having no further births (n = 5,236).