The association between pelvic floor deficiency and urinary incontinence: a retrospective study

Objective This study aimed to examine the association between pelvic floor deficiency and urinary incontinence. Methods We reviewed records from 2,745 women who visited our hospital between December 2019 and June 2022. Pelvic floor 4-dimension ultrasound was performed to screen the pelvic floor structural deficiency of postpartum women. Linear regression and generalized addictive model were used to analyse the relationship between urinary incontinence and pelvic floor parameters. In addition, population-attributable fraction value for UI were calculated for cystocele, urethral funnel separately and for the combinations of them. Results The bladder neck position (at rest), bladder neck position (at Valsalva), cystocele, and urethral funnel were risk factors for urinary incontinence after adjusting for additional confounding factors (BMI, age, education, gestational diabetes mellitus, abortion, neonatal weight, delivery mode, gestational weight gain, delivery mode, gravidity, parity) (OR: 0.695, 95% CI: 0.533–0.905; OR: 0.883, 95% CI: 0.805–0.969; OR: 1.255, 95% CI: 1.037–1.518; OR: 1.862, 95% CI: 1.556–2.228). The population-attributable fraction value for cystocele and urethral funnel were 4.7% and 8.0%, and the combined value was 12.7%. Conclusions Deficiency of anterior compartment including cystocele and urethral funnel, increases the risk of urinary incontinence.