Study Shows No Difference in Pelvic Pain or Urinary Symptoms Following Vaginal vs Cesarean Delivery

   There appears to be no difference in pelvic pain or urinary symptoms when comparing vaginal vs cesarean delivery through the first year after childbirth, according to research presented at the American College of Obstetricians and Gynecologists’ 59th Annual Clinical Meeting in Washington, D.C.

   Daniel G. Kiefer, MD, and colleagues at the Lehigh Valley Health Network, Allentown, Pennsylvania, conducted a prospective observational study of hospitalized, postpartum patients (N=169, 101 vaginal and 68 cesarean). After recording baseline demographic, medical history, perinatal factors, and social/support environment data, pelvic pain and urinary symptoms were assessed at six and 12 months using the previously validated Pelvic Pain and Urinary Urgency/Frequency Symptom Scale (PUF Questionnaire). The self-reported questionnaire assesses both how often a patient experiences problems (symptom score) along with the degree to which symptoms bother the patient (bother score), which are combined to a total PUF score with a range of 0-35. Most studies have suggested a score greater than 12 is indicative of significant symptoms.

   Following data analysis, the researchers  found that cesarean patients had more medical/perinatal problems and delivered earlier, but had no differences in social/support environment and did not rate their overall pre-delivery health differently. Twenty-eight percent of patients returned their follow-up surveys. The median total PUF score for vaginal deliveries at six months was 4 (range 0-10) compared to 3 (range 1-8) for cesarean deliveries (P=0.97). There were no differences either the symptom or bother score. Similarly at 12 months, there was no difference in PUF scores (median 4 for vaginal deliveries, 3 for cesarean).