Summary

Urinary and faecal incontinence are common and distressing problems after childbirth. Despite the extent of the morbidity, there is little evidence on which to base best management. This study included an investigation of antecedent factors, which may contribute to the problems, and a randomised controlled trial of conservative management. The multicentre design ensured both that there were adequate numbers and that different populations undergoing different types of health care would be included. Long term follow up of the participants at six and twelve years later has been carried out (see PROLONG). This showed that the modest gains in continence that women derived from conservative management (less urinary and faecal incontinence) at one year after delivery were not sustained at six or twelve years later. However, the prevalence of both urinary and faecal incontinence had increased.  The twelve year follow up included assessment of pelvic organ prolapse symptoms and signs in the randomised women. There were no differences in prolapse symptoms or objective prolapse measurement at 12 years.  

We used multivariate analysis to identify important antecedent factors leading to the publication of a number of linked papers on urinary and faecal incontinence and pelvic organ prolapse (see also PROLONG).  

Contact

Cathryn Glazener; c.glazener@abdn.ac.uk

Status

Completed

Publications

Glazener CMA, Herbison GP, Wilson PD, MacArthur C, Lang GD, Gee H, Grant AM. Conservative management of persistent postnatal urinary and faecal incontinence: a randomised controlled trial. BMJ 2001; 323 (7313); 593-596. 

Glazener CMA, Herbison P, MacArthur C, Grant AM, Wilson PD. Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: six year follow up. BMJ 2005; 330; (7487): 337-339. 

MacArthur C, Glazener CMA, Herbison P, Wilson PD, Lang D, Gee H. Obstetric practice and faecal incontinence three months after delivery. Br J Obstet Gynaecol 2001; 108; (7): 678-683. 

MacArthur C, Glazener CMA, Lancashire R, Herbison GP, Wilson PD, Grant AM. Faecal incontinence and mode of first and subsequent delivery: a six year longitudinal study. BJOG : an International Journal of Obstetrics & Gynaecology 2005, 112 (8), 1075-1082  

Glazener CMA, Herbison GP, MacArthur C, Lancashire R, McGee M, Grant A, Wilson PD. New postnatal urinary incontinence: obstetric and other risk factors in primiparae. British Journal of Obstetrics and Gynaecology 2006, 113 (2), 208-217 

MacArthur C, Glazener CMA, Wilson PD, Lancashire R, Herbison GP, Grant AM. Persistent urinary incontinence and delivery mode history: a six year longitudinal study. British Journal of Obstetrics and Gynaecology 2006, 113 (2), 218-224 

Dean N, Wilson D, Herbison P, Glazener C, Aung T, MacArthur C. Sexual function, delivery mode history, pelvic floor muscle exercises and incontinence: a cross-sectional study six years postpartum. Australian and New Zealand Journal of Obstetrics and Gynaecology 2008, 48 (3), 302-311

Rennie AM, Glazener CM, McGee MA, Herbison GP, MacArthur C, Grant AM et al. Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: long term follow up. [Oral presentation] Research in Midwifery and Perinatal Health Conference, University of Aston, Birmingham, 11 June 2003. 

Wilson PD, Glazener CM, McGee MA, Herbison GP, MacArthur C, and Grant AM. Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: long term follow-up study [Abstract]. Neurourol Urodyn 2002, 21 (4):370

Herbison P, Wilson D, Logan C, Glazener CMA, MacArthur C. Sexual function, type of delivery, incontinence and pelvic floor muscle exercises. [Oral presentation] 26th Annual Meeting of the International Urogynecology Association (IUGA ), Melbourne, Australia, December 2001 

Glazener C, MacArthur C, Hagen S, Elders A, Lancashire R, Herbison P, Wilson D, on behalf of The ProLong Study Group (2013).  Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes:  randomised controlled trial.  BJOG: Online 22 October 2013; 121 (1), 112-119

MacArthur C, Wilson D, Herbison P, Lancashire RJ, Hagen S, Toozs-Hobson P, Dean N, Glazener CM on behalf of The ProLong Study Group (2015). Urinary incontinence persisting after childbirth: extent, delivery history and effects in a 12 year longitudinal cohort study. BJOG:  Article first published online: 2 APR 2015:  DOI: 10.1111/1471-0528.13395