Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 1;27(1):e139-e145.
doi: 10.1097/SPV.0000000000000866.

Prevalence and Treatment of Postpartum Stress Urinary Incontinence: A Systematic Review

Alicia L Gonzales  1 , K Lauren Barnes  2 , Clifford R Qualls  3 , Peter C Jeppson  2
Affiliations

Prevalence and Treatment of Postpartum Stress Urinary Incontinence: A Systematic Review

Alicia L Gonzales et al. Female Pelvic Med Reconstr Surg. .

Abstract

Objectives: Many women present for treatment of stress urinary incontinence (SUI) after childbirth. This systematic review describes the efficacy of treatment options for SUI initiated during the 12 months after delivery.

Methods: We conducted a systematic review to identify studies comparing treatment options for SUI initiated in the 12 months after parturition. We searched MEDLINE from inception to February 2019, using Medical Subject Heading terms related to pregnancy and urinary incontinence. Preintervention and postintervention populations were compared using analysis of variance with Fisher least significant difference method used to determine efficacy between groups. Grades for Recommendation, Assessment, Development and Evaluation system was used to categorize quality of evidence as high, moderate, low, or very low.

Results: We double screened 4548 abstracts, identifying 98 articles for full-text review. Seven studies met the eligibility criteria and were included. Compared with a control group, the 4 interventions identified outperformed the control group (P < 0.001) using Fisher (with effect sizes noted): (1) supervised pelvic floor physical therapy (0.76), (2) electrical stimulation (0.77), (3) home physical therapy (PT) (0.44), and (4) surgery (not applicable). Based on Grades for Recommendation, Assessment, Development and Evaluation assessment, there was moderate evidence to support PT and electrical stimulation, with insufficient evidence for surgery. There were no significant differences in parity, age, or body mass index via analysis of variance. The overall strength of evidence is poor for the treatment of postpartum SUI; more data are needed to fully evaluate other treatment options.

Conclusions: All identified interventions demonstrated greater improvement for postpartum SUI over no treatment. Supervised PT ± electrostimulation was the most effective nonsurgical intervention.

PubMed Disclaimer

Conflict of interest statement

The authors have declared they have no conflicts of interest.

References

    1. Thom DH, Rortveit G. Prevalence of postpartum urinary incontinence: a systematic review. Acta Obstet Gynecol Scand 2010;89(12):1511–1522.
    1. Cunningham FG, Leveno KJ, Bloom SL, et al. Maternal Physiology. In: Williams Obstetrics. 25th ed. New York, NY: McGraw-Hill Education; 2018.
    1. Committee opinion no. 603: evaluation of uncomplicated stress urinary incontinence in women before surgical treatment. Obstet Gynecol 2014;123:1403–1407.
    1. Joanna Briggs Institute. The Joanna Briggs Institute Best Practice Information Sheet: the effectiveness of pelvic floor muscle exercises on urinary incontinence in women following childbirth. Nurs Health Sci 2011;13(3):378–381.
    1. Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med 2014;48(4):299–310.

Publication types

LinkOut - more resources