Displacement and recovery of the vesical neck position during pregnancy and after childbirth

• Published in: Neurourology and urodynamics Vol. 26; no. 3; pp. 372 - 376
• Main Authors: Wijma, Jacobus, Weis Potters, Annemarie E., van der Mark, Thomas W., Tinga, Dick J., Aarnoudse, Jan G.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-01-2007
• Subjects: Adolescent; Adult; Biomechanical Phenomena; Compliance; Delivery, Obstetric; Female; Humans; hysteresis; Muscle Contraction - physiology; Muscle, Skeletal - physiology; Parturition; pelvic floor; Pelvic Floor - diagnostic imaging; Pelvic Floor - physiology; Postpartum Period - physiology; Pregnancy - physiology; Prospective Studies; Ultrasonography; Urethra - diagnostic imaging; Urethra - physiology; urethral support; Urinary Bladder - diagnostic imaging; Urinary Bladder - physiology; vaginal delivery; Valsalva Maneuver - physiology
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.20354

Aims
(i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of the vesical neck supporting structures with and without pelvic floor contraction.
Methods
We focussed on the biomechanical properties of the vesical neck supporting structures during pregnancy and after childbirth by calculating the compliance and the hysteresis as a result from of abdominal pressure measurements and simultaneous perineal ultrasound.
Results
This study shows that compliance of the supporting structures remains relatively constant during pregnancy and returns to normal values 6 months after childbirth. Hysteresis, however, showed an increase after childbirth, persisting at least until 6 months post partum.
Conclusions
Vaginal delivery may stretch and or load beyond the physiological properties of the pelvic floor tissue and in this way may lead to irreversible changes in tissue properties which play an important role in the urethral support continence mechanism. Neurourol. Urodynam. 26:372–376, 2007. © 2007 Wiley‐Liss, Inc.