Women’s first pregnancy and delivery creates risk for stress urinary incontinence (SUI)
12-year follow-up highlights importance of pre- and post-natal consultation in the long-term management of stress urinary incontinence (SUI)
24 January 2006, Indianapolis, IN/USA and Ingelheim/Germany, 24 January 2006 – Data presented at the Nordic Uro-Gynecological Association (NUGA) meeting show that the risk of having SUI 12 years following first childbirth is significantly increased in those women with an onset of SUI symptoms following first delivery or during first pregnancy compared with those women who did not experience initial symptoms.1
Professor Gunnar Lose at the Department of Obstetrics and Gynaecology, University of Copenhagen, Glostrup Hospital in Denmark and co-author of the study, commented: “It is well known that pregnancy and childbirth can increase the risk of SUI symptoms. However, the long-term effects are less well established. During the preparation and immediately following childbirth, healthcare professionals and women develop a relationship whereby patients trust and are receptive to advice from their doctor. The doctor can encourage patients to be vigilant and seek professional help if they develop SUI symptoms in the months and years following childbirth.”
SUI is a stigma for many women, which means they may not seek treatment, sometimes for many years. This stigma is driven by a lack of awareness of what SUI is and women’s reluctance to seek professional help due to embarrassment or the incorrect belief that SUI is a natural part of aging.2,3
SUI symptoms can be simply identified by asking patients if they experience accidental leakage of urine during physical activities such as sneezing, coughing, laughing, lifting or exercising.3,4 SUI is the most common form of urinary incontinence in women.5 Despite its prevalence, sufferers do not often realize that treatment options specific for SUI exist, including lifestyle interventions, pelvic floor muscle training, pharmacological treatment (Yentreve®, duloxetine hydrochloride) and surgery.
The results from this 241-women study conclude that an onset of SUI symptoms following first delivery puts women at the greatest risk of long-term SUI. Specifically, of the women who had SUI symptoms after their first delivery, three out of four (78%) continued to display SUI symptoms after 12 years and more than half (56%) had SUI if the onset occurred during first pregnancy. The data also indicate that one in three (30%) with no symptoms before or during pregnancy and immediately following delivery also developed SUI within the 12-year observational period.1
The study then combined the women with onset of symptoms during first pregnancy or after delivery and looked at them three months later to determine their long-term risk of SUI. The study findings show that 10 out of 11 women had SUI 12 years after delivery if the mother experienced symptoms three months after childbirth. Forty out of 70 women experienced symptoms 12 years later if the woman had remission of symptoms three months after childbirth. Even among women with no symptoms before, during or after first pregnancy, 44 out of 146 women had SUI 12 years post delivery. Subsequent deliveries did not further increase the risk of developing SUI.1
“It appears from this study that the risk of long-lasting SUI is related to the time of onset and the duration of SUI after first pregnancy and delivery,” Lose said. “Healthcare professionals, particularly gynaecologists, should be aware of the long-term risks of SUI and take the opportunity of pre- and post-natal visits to discuss the risks and treatment options, thus helping women to avoid suffering in silence at a later stage.”
Notes to Editors:
Eli Lilly and Company and Boehringer Ingelheim
In November 2002, Eli Lilly and Company and Boehringer Ingelheim signed a long-term agreement to jointly develop and commercialize duloxetine hydrochloride. Duloxetine is currently being marketed for the treatment of depression, stress urinary incontinence and diabetic peripheral neuropathic pain. This partnership covers most countries worldwide with few exceptions. In the USA, the collaboration excludes neuroscience indications.
About Eli Lilly and Company
Lilly, a leading innovation-driven corporation, is developing a growing portfolio of best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers – through medicines and information – for some of the world`s most urgent medical needs.
About Boehringer Ingelheim
The Boehringer Ingelheim group is one of the world’s 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 144 affiliates in 45 countries and more than 36,000 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel products of high therapeutic value for human and veterinary medicine.
In 2004, Boehringer Ingelheim posted net sales of 8.2 billion euro while spending nearly one-fifth of net sales in its largest business segment Prescription Medicines on research and development.
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1 Viktrup L. The risk of stress urinary incontinence 12 years after the first pregnancy and delivery; a cohort study. Presented at NUGA Annual Meeting 20 January 2006, Oslo Norway
2 Understanding Stress Urinary Incontinence. Paul Abrams and Walter Artibani 2004
3 Fultz NH, Burgio K, Diokno AC, et al. Burden of stress urinary incontinence for community-dwelling women. Am J Obstet Gynecol 2003;189:1275-82
4 Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn 2002;21(2):167-78
5 Hampel C, Wienhold D, Benken N, et al. Prevalence and natural history of female incontinence. Eur Urol. 1997;32 Suppl 2:3-12 (Hampel data = 49% suffer from SUI with 30% prevalence)
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