Urinary incontinence (UI) is a common disorder reported by postpartum women. Data on its prevalence among postpartum women in Poland are limited, and previous studies have not reported the severity of symptoms or their impact on women’s quality of life. Vaginal delivery, especially first one, is a confirmed risk factor for UI, therefore the focus on primiparous women is essential. Although, it is recommended to assess the prevalence of pelvic floor dysfunction together with the level of bother experienced by women, only one third of studies have done so [1]. Therefore, the main aim of this study was to assess the prevalence of UI in primiparous Polish women at 3 months after vaginal delivery. The secondary objective was to examine bother related to postpartum UI and its impact on quality of life.

The data analyzed in this study were derived from a prospective observational cohort study, in which primiparous women were recruited during their hospital stay (24-72 hours after the delivery) and followed up at 3 months postpartum. Standardized online questionnaires were administered to assess the prevalence of UI, associated bother, and quality of life: Polish version of Pelvic Floor Distress Inventory (PFDI-20) and Polish version of Pelvic Floor Impact Questionnaire Short Form (PFIQ-SF).

A total of 491 women with mean age 30±4 years who completed questionnaires at 3 months postpartum were included in this analysis. Most women had a vaginal delivery (92.87%, n=456), while a small proportion underwent assisted vaginal delivery (vacuum extractor, 7.13%, n=35). Symptoms of UI at 3 months after first vaginal delivery were reported by 30.55 % (n=150) women. The UDI-6 scores ranged between 4.17-83.33, where median value was 20.83. Based on participants answers: 26.92% rated those symptoms as somewhat distressing, while 34.13% and 32.21% as moderately and quite a bit distressing, respectively. Fewer than 10% of responses indicated no bother related to symptoms of UI. Moreover, 61.49% (91/148) of women with postpartum UI declared impact on quality of life (UIQ-7>0), while 38.51% (57/148) did not. The UIQ-7 score ranged 0.00-100 with median value 4.76. Postpartum UI most frequently and most strongly affected the ability to perform physical activities (e.g., walking, swimming, or other exercise), followed by feelings of frustration and an impact on emotional health (e.g., nervousness, depression).

UI is a common dysfunction reported by primiparous women in Poland. Obtained prevalence is similar to those in previous studies from other countries, including systematic review with meta-analysis [1]. The results indicate that, in most participants, symptoms were bothersome and impacted their quality of life. Only a few women reported no bother or no impact on quality of life. To our knowledge, this is the first study of this type conducted in Poland. Our findings provide robust evidence for policymakers in Poland to prioritize the implementation of preventive and therapeutic programs addressing postpartum UI.

Nearly one in three women reported UI as bothersome and negatively affecting their quality of life. These findings provide the first data from Poland on this topic and underscore a clear need for targeted educational and therapeutic initiatives addressing this population. Further studies are needed to examine longitudinal changes over time.

Moossdorff-Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Prevalence, incidence and bothersomeness of urinary incontinence between 6 weeks and 1 year post-partum: a systematic review and meta-analysis. Int Urogynecol J. 2021;32(7):1675-93.