Ultrasonographic Assessment of the Effect of Mode of Delivery on Postpartum Posterior Urethrovesical Angle : A Prospective Cohort Study

Aim: This study aimed to investigate the impact of pregnancy and mode of delivery on postpartum posterior urethrovesical angle (PUVA) of continent women, as assessed by transperineal ultrasound (US).
Materials and Methods: The present study was a prospective study that included women with a singleton pregnancy and age-matched healthy volunteers as a control group. All patients underwent perineal US to assess the PUVA.
Results: One hundred pregnant women and 45 healthy controls were included. The baseline mean PUVA in pregnant women was 136.47 ±5.2° at rest and 103.8 ±1.89° at Valsalva maneuver; which were significantly higher than control group values (p <0.001). Pregnant women had statistically significant higher PUVA at rest and Valsalva maneuver than a control group six weeks and six months after delivery (p <0.001). Forty-one percent of the pregnant women underwent CS delivery, patients with VD had statistically significant higher PUVA at rest and stress six weeks after delivery than patients underwent CS delivery (p =0.014 and 0.015, respectively). Although a similar finding was observed at six months after delivery (p =0.04). However, the difference in PUVA according to the mode of delivery at six months was clinically subtle
Conclusion: In conclusion, the VD has a clinically subtle impact on the PUVA six months after delivery when compared to CS delivery. Thus, elective CS delivery should not be recommended on the basis of fear of higher risks of UI after VD.