Prevalência de frouxidão vaginal em mulheres primíparas 6 meses após o parto

Abstract

Introduction and hypotheses: Vaginal laxity (VL) is a common complaint and is associated with vaginal birth, multiparity, changes in the integrity of vaginal and muscular tissue, symptoms of urinary and prolapse and worse sexual function. Despite being common, the pathophysiology of VL is poorly investigated and underreported. Objective: To verify the prevalence of VL in primiparous undergoing vaginal birth or c- section; and its association with clinical, obstetric, urinary, intestinal and sexual factors associated for its occurrence. Methods: This is a cross-sectional observational study, developed at the Hospital das Clínicas of the Federal University of Minas Gerais (HC-UFMG) between July 2021 and January 2023. The inclusion criteria were: primiparous women who had a vaginal or cesarean section during the study period, who had no complaints of VL during pregnancy and who signed the informed consent form. Clinical and obstetric data were collected, and all participants responded to questionnaires on the impact of urinary incontinence, vaginal symptoms and sexual distress (ICIQ-SF, ICIQ-VS and FSDS-R) at recruitment and six months after birth. In the statistical analysis, for the association between the predictor variables and the outcomes of interest, the Chi-Square test was used for categorical variables; and the Mann-Whitney test for continuous variables. Univariate and multivariate logistic regression was performed, considering vaginal laxity as the outcome. In all statistical calculations, the significance level was 0.05. Results: One hundred participants were included for data analysis. The prevalence of VL in primiparous women was 8%. In the univariate analysis, stress and urgency urinary incontinence (UUI), coital incontinence and intestinal constipation were associated with VL symptoms. However, only UUI and coital incontinence were related to VL, in the multivariate analysis. The ICIQ-VS and ICIQ-SF scores showed a significant association with VL symptoms (p=0.015 and p=0.028, respectively). The ICIQ-VS, FSDS-R and ICIQ-SF scores increased the risk of VL by one-fold in participants in the univariate analysis. Only ICIQ-VS (vaginal symptoms) and ICIQ-SF remained associated with VL in the multivariate analysis (OR 1.32 and OR 1.25, respectively). Conclusion: The prevalence of VL in primiparous women was lower than that reported in other studies and showed an association with the occurrence of vaginal symptoms, urgency urinary incontinence and coital incontinence, six months postpartum.