Prevalence and Risk Factors of Urinary Dysfunction in Post-Cesarean Patients
Urinary Dysfunction in Post-Cesarean Patients
DOI:
https://doi.org/10.54393/pjhs.v6i6.3147Keywords:
Urinary Dysfunction, Cesarean Section, Postpartum, Risk Factors, Urinary IncontinenceAbstract
Urinary dysfunction (UD) following cesarean section (CS) is a significant but underexplored maternal health issue. While vaginal delivery is traditionally associated with pelvic floor disorders, emerging evidence suggests cesarean delivery may also pose risks. Objectives: To determine the prevalence of UD and its associated risk factors among post-CS women in Peshawar, Pakistan. Methods: This cross-sectional study was conducted at Peshawar Institute of Medical Sciences, Peshawar, including 195 postpartum women who underwent CS between January to March 2024. Participants were contacted via telephone and assessed using a standardized proforma, including the International Prostate Symptom Score (IPSS) to evaluate urinary symptoms. Statistical analysis was performed using SPSS version 25.0. To identify the potential risk factors, logistic regression was performed. Results: The prevalence of UD was 31 (15.8%). Common symptoms included urgency (74.2%), incomplete bladder emptying (54.8%), and urinary frequency (41.9%). Stress urinary incontinence was observed in 38.7%. Significant risk factors included age >35 years (p<0.0001), emergency CS (p=0.0001), operating time >60 minutes (p<0.0001), baby weight >4 kg (p=0.0001), and BMI >30 kg/m² (p<0.0001). Emergency CS was the strongest predictor (OR=6.31, p<0.001). Conclusions: Urinary dysfunction is a notable concern following cesarean delivery. Emergency CS, obesity, and prolonged surgery are key risk factors. Early identification and preventive strategies may improve postpartum care outcomes.
References
Gleicher S, Sebesta EM, Dmochowski RR. The Psychosocial Impact of Urinary Dysfunction. Urology Research and Practice. 2024 May; 50(3): 167. doi: 10.5152/tud.2024.23217. DOI: https://doi.org/10.5152/tud.2024.23217
Balik G, Güven ES, Tekin YB, Şentürk Ş, Kağitci M, Üstüner I et al. Lower Urinary Tract Symptoms and Urinary Incontinence During Pregnancy. LUTS: Lower Urinary Tract Symptoms. 2016 May; 8(2): 120-4. doi: 10.1111/luts.12082. DOI: https://doi.org/10.1111/luts.12082
Hakim S, Surya R, Yunita A, Hidayah GN, Santoso BI. Predicting Urinary Incontinence among Postpartum Women. eJournal Kedokteran Indonesia. 2023 Dec: 263-. doi: 10.23886/ejki.11.223.263. DOI: https://doi.org/10.23886/ejki.11.223.263
Sangsawang B and Sangsawang N. Stress Urinary Incontinence in Pregnant Women: A Review of Prevalence, Pathophysiology, And Treatment. International Urogynecology Journal. 2013 Jun; 24(6): 901-12. doi: 10.1007/s00192-013-2061-7. DOI: https://doi.org/10.1007/s00192-013-2061-7
Moossdorff-Steinhauser HF, Berghmans BC, Spaanderman ME, Bols EM. Prevalence, Incidence and Bothersomeness of Urinary Incontinence Between 6 Weeks and 1 Year Post-Partum: A Systematic Review and Meta-Analysis. International Urogynecology Journal. 2021 Jul; 32(7): 1675-93. doi: 10.1007/s00192-021-04877-w. DOI: https://doi.org/10.1007/s00192-021-04877-w
Zarzecka J, Pycek M, Pietrzykowska-Szczubelek K, Barcz E, Pomian A. Influence of Pregnancy and Mode of Delivery on Pelvic Floor Function: A Review of Literature. Ginekologia Polska. 2024; 95(10): 830-4. doi: 10.5603/gpl.98418. DOI: https://doi.org/10.5603/gpl.98418
Beyazıt A, Hakverdi AU, Gözükara KH. The Effect of Pregnancy on Urinary Symptoms. Cureus. 2023 Aug; 15(8). doi: 10.7759/cureus.44232. DOI: https://doi.org/10.7759/cureus.44232
Saba N, Rasheed I, Rasheed S, Khan ZA, Fatima A, Nadeem S. Long-Term Impact of Mode of Delivery on Urinary Stress Incontinence. Pakistan Journal of Medical and Health Sciences. 2022 May 22; 16(04): 697-. doi: 10.53350/pjmhs22164697. DOI: https://doi.org/10.53350/pjmhs22164697
Baud D, Sichitiu J, Lombardi V, De Rham M, Meyer S, Vial Y et al. Comparison of Pelvic Floor Dysfunction 6 Years After Uncomplicated Vaginal Versus Elective Cesarean Deliveries: A Cross-Sectional Study. Scientific Reports. 2020 Dec; 10(1): 21509. doi: 10.1038/s41598-020-78625-3. DOI: https://doi.org/10.1038/s41598-020-78625-3
López-López AI, Sanz-Valero J, Gómez-Pérez L, Pastor-Valero M. Pelvic Floor: Vaginal or Caesarean Delivery? A Review of Systematic Reviews. International Urogynecology Journal. 2021 Jul; 32(7): 1663-73. doi: 10.1007/s00192-020-04550-8. DOI: https://doi.org/10.1007/s00192-020-04550-8
Dowais R, Albeitawi S, Sindiani A, Bakkar S, Ababneh N, Abu Kaf D et al. A Retrospective Study Analyzing the Incidence of Urine Incontinence after Cesarean Section Delivery in Comparison with Vaginal Delivery. Current Womens Health Reviews. 2025 May; 21(3): e300124226480. doi: 10.2174/0115734048255110231018071943. DOI: https://doi.org/10.2174/0115734048255110231018071943
Huang J, Chan CK, Yee S, Deng Y, Bai Y, Chan SC et al. Global Burden and Temporal Trends of Lower Urinary Tract Symptoms: A Systematic Review and Meta-Analysis. Prostate Cancer and Prostatic Diseases. 2023 Jun; 26(2): 421-8. doi: 10.1038/s41391-022-00610-w. DOI: https://doi.org/10.1038/s41391-022-00610-w
Moore L, Malde S, Dasgupta P, Sahai A, Raison N. Inheritance Patterns of Lower Urinary Tract Symptoms in Adults: A Systematic Review. British Journal of Urology International. 2025 Feb; 135(2): 192-203. doi: 10.1111/bju.16517. DOI: https://doi.org/10.1111/bju.16517
Hajebrahimi S, Gomes CM, Farhadi F, Khan HS, Sadeghi‐Bazarghani H, Mourad S et al. Population‐Based Survey of Urinary Incontinence, Overactive Bladder, and Other Lower Urinary Tract Symptoms in Five Developing Countries: Results of the BEBIC Study. Neurourology and Urodynamics. 2025 Feb; 44(2): 294-304. doi: 10.1002/nau.25623. DOI: https://doi.org/10.1002/nau.25623
Wang Q, Manodoro S, Lin H, Li X, Lin C, Jiang X. Risk Factors and A Predictive Model for Mixed Urinary Incontinence among Parous Women: Insights from A Large-Scale Multicenter Epidemiological Investigation. Digital Health. 2025 Apr; 11: 20552076251333661. doi: 10.1177/20552076251333661. DOI: https://doi.org/10.1177/20552076251333661
Warner K, Avery GA, Battula S, Esparza A, Pinto A, Heisler CA. Risk Factors for Postpartum Urinary Retention: A Case-Control Study. American Journal of Obstetrics and Gynecology. 2024 Apr; 230(4): S1247-8. doi: 10.1016/j.ajog.2024.02.159. DOI: https://doi.org/10.1016/j.ajog.2024.02.159
Zakzouk NA, Habib FM, Ezzat R, Mohamed HA. Voiding Dysfunction between Women Following Vaginal Vs Cesarean Section Delivery: A Comparative Study. Menoufia Nursing Journal. 2023 Sep; 8(3): 217-33. doi: 10.21608/menj.2023.329161. DOI: https://doi.org/10.21608/menj.2023.329161
Khalil AS, Flora S, Hagglund K, Aslam M. Increased Bladder Injury Rate During Emergency and Repeat Cesarean Section. Journal of the Turkish German Gynecological Association. 2023 Jun; 24(2): 97. doi: 10.4274/jtgga.galenos.2023.2022-6-15. DOI: https://doi.org/10.4274/jtgga.galenos.2023.2022-6-15
Khasanov A, Nurullina D, Yarullina E. Urinary Retention as A Consequence of Birth Injury to the Mother. Practical Medicine. 2024; 22: 58–62. doi: 10.32000/2072-1757-2024-4-58-62. DOI: https://doi.org/10.32000/2072-1757-2024-4-58-62
Chen Y, Xu C, Saiding Q, Chi X, Chu L, Wang X et al. Association of Cesarean Delivery Timing with Pelvic Floor Muscle Function and Urine Incontinence: A Propensity Score‐Matched Study. Smart Medicine. 2022 Dec; 1(1): e20220018. doi: 10.1002/SMMD.20220018. DOI: https://doi.org/10.1002/SMMD.20220018
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments
