Influence of the type of delivery on the outcome of urinary incontinence physical therapy treatment Influência do tipo de parto no resultado do tratamento fisioterapêutico na incontinência urinária

Objectives: To analyze the influence of the type of delivery on the pelvic floor muscle strength (PFMS) of women with urinary incontinence (UI), before and after physical therapy intervention and the relationship between the different types of UI and type of delivery. Materials and Methods: In this nonrandomized, uncontrolled clinical trial, 46 women (35 to 78 years) with a medical diagnosis of UI (stress – SUI, mixed – MUI, urgency – UUI), who did not undergo gynecological surgery were included. The voluntaries were evaluated (perineometry and bidigital test) and undertook a conservative treatment consisting of pelvic floor exercise and transvaginal electrical stimulation. Results: The mean age was 53.6±10.5 years. Half the voluntaries had MUI, 39.1% had SUI and 10.9% UUI. After treatment, the women who had had normal delivery presented a significant increase in the PFMS, both measured by the perineometer (p=0.031; paired Student′s T test) and by the bidigital test (p≤0.05; Wilcoxon’s Test), while the women who had cesarean section or both types of delivery did not present a significant gain. The relationship between the type of delivery and types of UI did not present a significant difference. Over 80% of the women that had normal delivery or cesarean section were continent or satisfied after the treatment. Conclusion: The voluntaries that had normal delivery presented the greatest gains in the PFMS. Notwithstanding, the type of delivery did not influence the results of the physical therapy intervention regarding urinary continence, since the majority of the women treated reported being continent or satisfied with the treatment. Objetivos: Analisar a influência do tipo de parto na for a muscular do assoalho pélvico (FMAP) de mulheres com incontinência urinária (IU), antes e depois de interven o fisioterapêutica e determinar a rela o entre os tipos de IU e tipos de parto. Materiais e Métodos: Neste ensaio clínico, de bra o único e n o controlado foram incluídas 46 mulheres (35 a 78 anos) com diagnóstico médico de IU (de esfor o – IUE, de urgência – IUU ou mista – IUM), que n o realizaram cirurgia ginecológica. As voluntárias foram avaliadas e submetidas a tratamento conservador, constituído de exercícios perineais e eletroestimula o transvaginal. Resultados: A média de idade foi de 53,6±10,5 anos. Metade das voluntárias apresentou IUM, 39,1% apresentaram IUE e 10,9% IUU. Após o tratamento, as mulheres que realizaram parto normal apresentaram aumento significativo da FMAP, tanto mensurada pelo perine metro (p=0,031; teste t student para amostras pare