Risk of new-onset urinary incontinence after forceps and vacuum delivery in primiparous women

Objective: We sought to determine the incidence of new-onset urinary incontinence after forceps and vacuum delivery compared with spontaneous vaginal delivery. Study Design: We performed a prospective study in primiparous women delivered by forceps (n = 90), vacuum (n = 75), or spontaneous vaginal delivery (n = 150). Follow-up for urinary incontinence was at 2 weeks, 3 months, and 1 year after delivery. Results: The incidence of urinary incontinence was similar in the 3 groups at 2 weeks after delivery. The proportion of women developing new-onset urinary incontinence decreased significantly over time in the spontaneous vaginal (P = .003) and vacuum delivery groups (P = .009) but not in the forceps group (P = .2). No relationship of urinary incontinence with vaginal lacerations, epidural anesthesia, length of second stage of labor, or infant birth weight was seen. Conclusions: In primiparous women, urinary incontinence after forceps delivery is more likely to persist compared with spontaneous vaginal or vacuum delivery. (Am J Obstet Gynecol 2001;185:1318-24.)