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Risk of new-onset urinary incontinence after forceps and vacuum delivery in primiparous women
Authors:Lily A Arya MD  Neil D Jackson MD  Deborah L Myers MD  Anila Verma MBBS  PhD
Institution:Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Women and Infant's Hospital, Brown University School of Medicine, Providence, RI, USA.
Abstract:OBJECTIVE: We sought to determine the incidence of new-onset urinary incontinence after forceps and vacuum delivery compared with spontaneous vaginal delivery. STUDY DESIGN: We performed a prospective study in primiparous women delivered by forceps (n = 90), vacuum (n = 75), or spontaneous vaginal delivery (n = 150). Follow-up for urinary incontinence was at 2 weeks, 3 months, and 1 year after delivery. RESULTS: The incidence of urinary incontinence was similar in the 3 groups at 2 weeks after delivery. The proportion of women developing new-onset urinary incontinence decreased significantly over time in the spontaneous vaginal (P =.003) and vacuum delivery groups (P =.009) but not in the forceps group (P =.2). No relationship of urinary incontinence with vaginal lacerations, epidural anesthesia, length of second stage of labor, or infant birth weight was seen. CONCLUSIONS: In primiparous women, urinary incontinence after forceps delivery is more likely to persist compared with spontaneous vaginal or vacuum delivery.
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