Development of a urinary assessment index in the delivery for prevention of postpartum urinary incontinence

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K24233
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: Toyama Prefectural University
• Principal Investigator: KITAJIMA Yuka 富山県立大学, 看護学部, 助教 (00846131)
• Project Period (FY): 2019-08-30 – 2022-03-31
• Keywords: 産褥早期 / 下部尿路機能 / 下部尿路症状 / 膀胱内尿量 / 排尿アセスメント

Outline of Final Research Achievements

With the aim of developing a urinary assessment index for the prevention of postpartum urinary incontinence, we aimed to explore the characteristics of lower urinary tract function in the early puerperium from late pregnancy to early puerperium based on actual lower urinary tract symptoms and urinary bladder volume. We longitudinally investigated lower urinary tract symptoms and urinary bladder volume in women with singleton pregnancies who delivered vaginally, from late pregnancy to early puerperium.
The early puerperium was characterized by a tendency to bladder fullness, as urinary bladder volume was increased while the bladder sensation was diminished. Furthermore, the higher the ICIQ-SF score in late pregnancy, the more prominent the　diminution in bladder sensation in Day 4. The results suggest that lower urinary tract symptoms after Day 4 of puerperium may reflect the effects of hormonal changes associated with pregnancy as well as nerve compression associated with delivery.

Free Research Field

助産学

Academic Significance and Societal Importance of the Research Achievements

本研究は、膀胱内尿量を客観的に測定したことで、産褥早期は尿量が多くなる一方で産褥日数に限らず尿意が減弱している可能性を明らかにした。褥婦の自覚的尿意のみに頼らず客観的に尿量を評価することの重要性が示され、膀胱過伸展の予防に向けた排尿アセスメントとケアの発展に寄与できると考える。
また、妊娠後期のICIQ-SFスコアが高いほど、つまり尿失禁の重症度が高いほど産褥4日に尿意減弱を有しやすい結果が得られた。妊娠後期にICIQ-SFを用い尿失禁の有無と程度を評価することで、産褥早期の尿意減弱のリスクを予測でき、尿意減弱に伴う膀胱過伸展やその後の下部尿路症状の予防に向けた早期介入が可能になると考える。