PITMAN, NJ, USA (Press Release) - June 26, 2008 - Vaginal childbirth is known to be associated with trauma to the pelvic floor, which causes such problems as urinary incontinence, pelvic organ descent and other pelvic floor disorders. Other genetic and environmental factors also play a role in developing urinary incontinence. Many women are embarrassed by these issues, so the problems are often not reported or go undiagnosed, leading to a poor quality of life for many women. Urologic practitioners must step in and recognize risk factors and present treatment options which fit each woman's lifestyle and comfort level. Urologic Nursing explores these topics in four continuing nursing education articles in the June 2008 issue, a special issue on women's health.

Childbirth and Other Factors Pose Risks for Urinary Incontinence

Urinary incontinence (UI) is an under-reported and under-diagnosed problem that affects women of all ages. While research shows the risk of UI increases two to three times following pregnancy and vaginal childbirth, other genetic and environmental factors (such as pelvic bone shape, aging and pelvic organ prolapse) can cause UI.

In the June 2008 issue of Urologic Nursing, Lianne F. Herbruck reviews the types of urinary incontinence and risk factors for developing the condition, with a focus on stress urinary incontinence, the most common type of UI in women of childbearing age. The author says the life-altering financial, emotional and social burdens associated with UI affect women throughout their lives.

Herbruck recommends future researchers investigate which exact genetic and environmental factors have a hand in UI and place some women at greater risk. She also suggests studies focus on modifications and improvements that can be made in labor and birth procedures to lessen the damage to the pelvic floor. (Urinary Incontinence in the Childbearing Woman; Lianne F. Herbruck, MSN, RN, CNM; Urologic Nursing; June 2008; www.suna.org .

Cesarian Sections Cause Greater Health Risks and Don't Eliminate Urinary Incontinence

More women are electively choosing to deliver their babies through cesarian section (CS) in hopes of protecting their pelvic floor and reducing the risk for urinary incontinence (UI). Research to date shows this is not a foolproof method.

In the June 2008 issue of Urologic Nursing, Lianne F. Herbruck reviews the labor and delivery processes for vaginal childbirth and CS, as well as vaginal, perineal and anal injuries which may occur. While CSs have been shown to limit damage and tears to the pudendal area, the procedure does not completely protect from UI or other pelvic floor disorders. Cesarian sections also put women at greater risk for hemorrhage, uterine rupture and urinary tract injury, and they are twice as likely to be readmitted to the hospital for complications after birth.

Future studies should critically examine UI and the relationship between CS and vaginal delivery, as well as development of UI long term, says the author. Herbruck says vaginal birth is still the preferred method of delivery, and that boosting women's confidence in vaginal birth is critical. She suggests instilling safeguards to improve the labor and delivery process and ensure practitioners have the necessary skills to perform deliveries. (The Impact of Childbirth on the Pelvic Floor; Lianne F. Herbruck, MSN, RN, CNM; Urologic Nursing; June 2008; www.suna.org .

Early Diagnosis and Patient Education Vital to Treating Stress Urinary Incontinence

Women who receive an early diagnosis for stress urinary incontinence (SUI) have an opportunity to take preventative measures to reduce their risk for the condition. Once a woman is diagnosed, she should be informed of all treatment options so she can choose the care plan that makes her most comfortable, fits her lifestyle and improves her quality of life. In a two-part article in the June 2008 issue of Urologic Nursing, Lianne F. Herbruck presents an overview of diagnosis and treatment options as well as education and management tools for urologic practitioners.

Treatment options for SUI include such measures as pelvic floor exercises, managing urine leaks with tampons and pads, biofeedback, vaginal cones, pessaries, pharmacologic measures and surgery, says the author. The challenge for urologic nurses, says Herbruck, is recognizing each woman's tolerance level and finding the best treatment option for each patient.

Patient education and support is vital to treatment compliance, says Herbruck. Financial and social costs to women are significant, and the full magnitude of the problem is unknown because many women choose to live with UI. Practitioners should be well educated on risk factors for UI and the most effective treatments for women in early stages of developing UI; the sooner treatment begins, the smaller the risk for more aggressive treatments, such as surgery, later in life. (Stress Urinary Incontinence: An Overview of Diagnosis and Treatment Options; Stress Urinary Incontinence: Prevention, Management, and Provider Education; Lianne F. Herbruck, MSN, RN, CNM; Urologic Nursing; June 2008; www.suna.org .

The Society of Urologic Nurses and Associates

[ PRESS RELEASE ]

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