Evidence map›Paper›PMID 26874810›Full record

SynthesisEuropean urology2016

Long-term Impact of Mode of Delivery on Stress Urinary Incontinence and Urgency Urinary Incontinence: A Systematic Review and Meta-analysis.

Riikka M Tähtinen, Rufus Cartwright, Johnson F Tsui, Riikka L Aaltonen, Yoshitaka Aoki, Jovita L Cárdenas, Regina El Dib, Kirsi M Joronen, Sumayyah Al Juaid, Sabreen Kalantan and 12 more

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European urology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03194789 (The Effect of Footwear Generated Biomechanical Manipulation on Symptoms of Stress Urinary Incontinence), which is not on this map. Cited by 90 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 8 pooled it
13.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03194789 nacompletednot on this mapstarted 2017, after this paper: background citation

The Effect of Footwear Generated Biomechanical Manipulation on Symptoms of Stress Urinary Incontinence

TypeinterventionalSponsorMontefiore Medical CenterRan2017 to 2023Enrolled55ConditionsPelvic Floor Disorders, Stress Urinary IncontinenceArmsFootwear Generated Bio-Mechanical Manipulation (using shoes with pertupods) along with Traditional Pelvic Floor Therapy, Traditional Pelvic Floor Therapy
3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 8 syntheses or guidelines pooled it, 196 citations in OpenAlex.

  1. Pooled it
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  3. Single-incision sling operations for urinary incontinence in women.The Cochrane database of systematic reviews · 2023
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  13. Risk factors for subgaleal hemorrhage and adverse early neonatal outcomes: a single-center cohort study with exclusive use of forceps.Journal of perinatology : official journal of the California Perinatal Association · 2026
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  20. The effect of powerlifting on urinary incontinence in women.Central European journal of urology · 2026
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30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors at 17 institutions in 9 countries.

Riikka M TähtinenDepartment of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland; Department of Obstetrics and Gynecology, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
Rufus CartwrightDepartment of Epidemiology and Biostatistics, Imperial College London, London, UK; Department of Urogynecology, Imperial College London, London, UK.
Johnson F TsuiDepartment of Urology, North Shore-LIJ Lenox Hill Hospital, New York, NY, USA; Institute for Bladder and Prostate Research, New York, NY, USA.
Riikka L AaltonenDepartment of Obstetrics and Gynecology, University of Turku and Turku University Hospital, Turku, Finland.
Yoshitaka AokiDepartment of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan.
Jovita L CárdenasDepartment of Clinical Practice Guidelines, National Center for Health Technology Excellence, México, Mexico.
Regina El DibDepartment of Anesthesiology, Botucatu Medical School, São Paulo State University, São Paulo, Brazil.
Kirsi M JoronenDepartment of Obstetrics and Gynecology, University of Turku and Turku University Hospital, Turku, Finland.
Sumayyah Al JuaidDepartment of Obstetrics and Gynecology, King Saud bin Abdulaziz University for Health Sciences, and King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
Sabreen KalantanDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Michal KochanaFaculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
Malgorzata KopecFaculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
Luciane C LopesPharmaceutical Science Master Courde, University of Sorocaba, São Paulo, Brazil; School of Pharmaceutical Sciences, Department of Drugs and Medications, Paulista State University, São Paulo, Brazil.
Enaya MirzaDepartment of Obstetrics and Gynecology, St. Mary's Hospital, London, UK.
Sanna M OksjokiDepartment of Obstetrics and Gynecology, University of Turku and Turku University Hospital, Turku, Finland.
Jori S PesonenDepartment of Urology, Päijät-Häme Central Hospital, Lahti, Finland.
Antti ValpasDepartment of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.
Li WangMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Canada; Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China.
Yuqing ZhangDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Diane Heels-AnsdellDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Gordon H GuyattDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Kari A O TikkinenDepartments of Urology and Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: kari.tikkinen@gmail.com.
McMaster University · CAJagiellonian University · PLTurku University Hospital · FIImperial College London · GBKing Faisal Specialist Hospital & Research Centre · SAKing Saud bin Abdulaziz University for Health Sciences · SAKuopio University Hospital · FILenox Hill Hospital · USPäijät-Hämeen Keskussairaala · FISichuan University · CNSouth Karelia Central Hospital · FISt. Mary's Hospital · GBUniversidade Estadual Paulista (Unesp) · BRUniversidade Paulista · BRUniversity of Fukui · JPUniversity of Helsinki · FIUniversity of Turku · FI

Funding

Medical Research Council G1100377
6 · The paper itself

Abstract

contextStress urinary incontinence (SUI) and urgency urinary incontinence (UUI) are associated with physical and psychological morbidity, and large societal costs. The long-term effects of delivery modes on each kind of incontinence remain uncertain.

objectiveTo investigate the long-term impact of delivery mode on SUI and UUI. EVIDENCE ACQUISITION: We searched Medline, Scopus, CINAHL, and relevant major conference abstracts up to October 31, 2014, including any observational study with adjusted analyses or any randomized trial addressing the association between delivery mode and SUI or UUI ≥1 yr after delivery. Two reviewers extracted data, including incidence/prevalence of SUI and UUI by delivery modes, and assessed risk of bias. EVIDENCE SYNTHESIS: Pooled estimates from 15 eligible studies demonstrated an increased risk of SUI after vaginal delivery versus cesarean section (adjusted odds ratio [aOR]: 1.85; 95% confidence interval [CI], 1.56-2.19; I(2)=57%; risk difference: 8.2%). Metaregression demonstrated a larger effect of vaginal delivery among younger women (p=0.005). Four studies suggested no difference in the risk of SUI between spontaneous vaginal and instrumental delivery (aOR: 1.11; 95% CI, 0.84-1.45; I(2)=50%). Eight studies suggested an elevated risk of UUI after vaginal delivery versus cesarean section (aOR: 1.30; 95% CI, 1.02-1.65; I(2)=37%; risk difference: 2.6%).

conclusionsCompared with cesarean section, vaginal delivery is associated with an almost twofold increase in the risk of long-term SUI, with an absolute increase of 8%, and an effect that is largest in younger women. There is also an increased risk of UUI, with an absolute increase of approximately 3%. PATIENT SUMMARY: In this systematic review we looked for the long-term effects of childbirth on urinary leakage. We found that vaginal delivery is associated with an almost twofold increase in the risk of developing leakage with exertion, compared with cesarean section, with a smaller effect on leakage in association with urgency.

Indexed as

ParturitionCesarean SectionFemaleHumansRisk FactorsTime FactorsUrinary Incontinence, StressUrinary Incontinence, UrgeVaginaCesarean sectionForcepsInstrumental deliveryStress urinary incontinenceSystematic reviewUrgency urinary incontinenceVacuumVaginal delivery

Identifiers

PMID26874810
PMCPMC5009182
OpenAlexW2253620301

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.