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document
A comparison of urinary and sexual outcomes in women experiencing vaginal and Caesarean births . OBJECTIVE To evaluate the urinary and sexual consequences of vaginal delivery compared with Caesarean section . METHODS We performed a cohort analysis of data from a randomized controlled trial of episiotomy conducted in 3 Montreal hospitals in 1990-1991 . Of the 999 trial participants for whom follow-up data were available , 135 delivered by Caesarean section ( CS ) , and 864 had a vaginal birth ( VB ) . After stratifying for parity , we compared rates of urinary incontinence ( UI ) and sexual functioning at 3 months postpartum in women who had a VB with the rates in women who had a CS . RESULTS Primiparous women reported unspecified UI at 3 months postpartum more often ( 17.9 % ) in the VB group than in the CS group ( 6.4 % ) . This difference remained significant whether or not there was a prior history of UI . Multiparous women showed no difference in rates of UI ( VB 17.1 % vs. CS 16.0 % ) , whether there was a prior history of UI or not . Stress incontinence was greater among primiparous women in the VB group ( VB 34.5 % vs. CS 12.8 % ) regardless of prior UI history , but the proportion of women whose UI was severe enough to wear a pad was similar in primiparous women ( VB 16.0 % , CS 15.4 % ) and multiparous women ( VB 23.8 % , CS 25.0 % ) . Women 's sexual dissatisfaction was greater among primiparous women who had a vaginal birth ( VB 70.1 % , CS 54.5 % ) , but in multiparous women , the rates of sexual dissatisfaction were similar ( VB 64.2 % , CS 71.4 % ) . The frequency of dyspareunia for each mode of delivery was similar in primiparous women ( VB 30.7 % , CS 31.6 % ) . Overall , both primiparous and multiparous women who had intact perineums after VB had less dyspareunia than those undergoing CS ( VB 26.2 , CS 40.7 % ) . However , the proportion of women experiencing dyspareunia was greatest among those who had an episiotomy with or without forceps .
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Intervention_Surgical
vaginal delivery
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Intervention_Surgical
Caesarean section
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Intervention_Surgical
Caesarean section ( CS )
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Intervention_Other
vaginal birth ( VB )
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Outcome_Physical
urinary and sexual consequences
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Outcome_Physical
urinary incontinence ( UI )
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Outcome_Physical
sexual functioning
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Outcome_Physical
UI
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Outcome_Physical
rates of
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Outcome_Physical
Stress incontinence
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Outcome_Physical
UI
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Outcome_Mental
Women 's sexual dissatisfaction
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Outcome_Physical
sexual dissatisfaction
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Outcome_Physical
frequency of dyspareunia
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Outcome_Physical
dyspareunia
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Outcome_Physical
dyspareunia
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Participant_Sex
women
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Participant_Condition
vaginal and Caesarean
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Participant_Condition
vaginal delivery
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Participant_Sample-size
999
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Participant_Sample-size
135
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Participant_Sample-size
864
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Participant_Sex
women
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Participant_Sex
women