C Glazener

Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta‐analysis

Background  The efficacy and safety of mesh/graft in surgery for anterior or posterior pelvic organ prolapse is uncertain.

Obstetric practice and faecal incontinence three months after delivery

Objective To determine whether obstetric and maternal factors relate to faecal incontinence at three months postpartum.

New postnatal urinary incontinence : obstetric and other risk factors in primiparae

Objective  To identify obstetric and other risk factors for urinary incontinence that occurs during pregnancy or after childbirth.

A two‐centred pragmatic randomised controlled trial of two interventions of postnatal support

Objectives To establish whether providing additional postnatal support during the early postnatal months influences womens physical and psychological health and to identify health service benefits.

Childbirth and prolapse : long-term associations with the symptoms and objective measurement of pelvic organ prolapse

To investigate prolapse symptoms and objectively measured pelvic organ prolapse, 12 years after childbirth, and association with delivery mode history.

Satisfaction and the three C's: continuity, choice and control. Women's views from a randomised controlled trial of midwife-led care

Objective 1. To explore whether there are differences in womens satisfaction with care in a midwife‐managed delivery unit compared with that in a consultant‐led labour ward. 2. To compare factors relating to continuity, choice and control between the two randomised groups.

Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes: randomised controlled trial

To determine the long‐term (12‐year) effects of a conservative nurse‐led intervention for postnatal urinary incontinence.

Faecal incontinence persisting after childbirth: a 12 year longitudinal study

To investigate persistent faecal incontinence (FI) 12 years after birth and association with delivery mode history and quality of life.

Urinary incontinence persisting after childbirth : extent, delivery history, and effects in a 12-year longitudinal cohort study

To investigate the extent of persistent urinary incontinence (UI) 12 years after birth, and association with delivery‐mode history and other factors.

Authors' comment: A report from #BlueJC: ‘How to manage incontinence after childbirth?’

Sir, We appreciate the compliment of having our paper chosen for Journal Club discussion and judging by their comments, your contributors went into the subject in great depth. We agree with their summary and conclusions. In particular, the finding that many women were not performing any PFMT despite still having urinary incontinence was noteworthy. We feel that follow-up of women who have early evidence of pelvic floor dysfunction will demonstrate how much childbirth affects maternal health in the long term. There are major implications for health service provision, especially as our population ages. CMA Glazener, GP Herbison, C Bain & PD Wilson, on behalf of the ProLong Study Group Health Services Research Unit, University of Aberdeen Medical School, Foresterhill, Aberdeen, AB25 2ZD, UK Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen AB25 2ZD, UK Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand