RISK FACTORS ASSOCIATED WITH STRESS INCONTINENCE IN SECOND PREGNANCY

Dr. Aisha Ghafoor, Dr. Anam Raza, Dr.Urooj Malik, Dr. Talha Mansoor, Dr. Tayyaba Kiran, Dr. Ghulam Abbas, Dr.Sobia Javaid,

INTRODUCTION:

Stress incontinence is a condition when bladder leaks urine during exertion or any physical activity like coughing, sneezing, lifting heavy objects , exercise etc. it occurs when the bladder controlling muscles not working properly. Both urethra and bladder are surrounded by muscles called pelvic floor muscles. From bladder through urethra the urine flows outside and this opening of urethra is surrounded by a sphincter which prevents urine leakage (webmed, 2005-2016). If these muscles became weak or not work properly, unwanted urine may flow and it is not concerned with psychological stress (Mayo foundation 1998-2017).

There are three main contributing muscles which form pelvic floor muscles, these muscles are: levator ani muscles, coccyges muscles, fascia around the muscles, levator ani muscles performed special role during childbirth in cervical dilatation , due to role of these muscles in supporting vagina, urethra, and anal canal a number of problems could occur if any injury to these muscles happen and stress incontinence is one of them (Sophie Fidoe, 29 January 2017).

There are different causes of pelvic floor muscle weakness, for.eg: childbirth through vaginal delivery, some medications, injury of urethra , nerve damage , urinary tract infections , obesity , age, smoking, (KM Luber, 2004). Other risk factors which may contribute to stress urinary incontinence includes, estrogen depletion, diabetes, childhood nocturnal diuresis, race, loss of fecal control, delirium, less intake of fluid, stressful physical activity, environmental hurdles or barriers, stroke, impaired cognition, immobility, pelvic floor muscle weakness, pregnancy, medications caffeine, alcohol, diuretics etc. (mark deutchman,6 December, 2005). The major contributing risk factor of urinary incontinence is childbirth through vaginal delivery and the risk increases as the number of deliveries increases.