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  • Title: Is cesarean section a real panacea to prevent pelvic organ disorders?
    Author: Koc O, Duran B, Ozdemırcı S, Bakar Y, Ozengin N.
    Journal: Int Urogynecol J; 2011 Sep; 22(9):1135-41. PubMed ID: 21626039.
    Abstract:
    INTRODUCTION AND HYPOTHESIS: The aim of this study is to compare the pelvic floor muscle strength after vaginal delivery vs. after cesarean section. METHODS: Five groups of 50 cases each were designated as follows: nullipara (control group), spontaneous vaginal delivery (SVD), repeat SVD (SVD-R), cesarean section (CS), and repeat CS (CS-R). Perineometric measurements, stress urinary incontinence (SUI) symptoms, pelvic organ prolapse quantification examinations, and Incontinence-Specific Quality of Life Questionnaire (IQOL) were evaluated. RESULTS: In all delivery groups, pelvic muscle strength was significantly lower than the control group (65.10 ± 15.69, 56.29 ± 17.39, 54.28 ± 20.08, 56.82 ± 17.62, and 57.92 ± 16.45 (cm H(2) ± SD) for the control, SVD, SVD-R, CS, and CS-R groups, respectively; p < 0.05). However, no significant difference was found among the delivery groups. There were significant differences in SUI symptoms between the control (2%) and SVD-R (26%) groups and between the SVD (10%) and SVD-R groups (p < 0.001 and p = 0.037, respectively). No statistically significant correlations between IQOL and perineometric measurements were noted (r = 0.097 and p = 0.598). CONCLUSIONS: Pregnancy increases postpartum muscle weakness independent of the mode of delivery. Increased SUI symptoms are associated with vaginal delivery.
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