Prevalence and Determinants of Lower Urinary Tract Symptoms before and during Pregnancy in a Cohort of Nigerian Women

Background: Pregnancy and childbirth are thought to be associated with development of lower urinary tract symptoms (LUTS). The study aimed at ascertaining prevalence rates of LUTS before and during pregnancy; the determinants and perceived effects of these symptoms on the life of the women. Materials and Methods: Questionnaires in which LUTS were defined according to recommendations of International Continence Society was administered on consecutive women who delivered at ?37 weeks' gestation to ascertain the presence or absence of LUTS before and during pregnancy and perceived effects on their life. Data was also collected on their socio-demographic and obstetric features. Descriptive statistics and relationship between LUTS and other variables were analyzed using SPSS version 16. Results: Prevalence rates of LUTS before and during pregnancy were 52.9 and 89.2; respectively; and mostly included nocturia and stress urinary incontinence. Women were more likely to develop LUTS during pregnancy (P = 0.002; OR 4.99; 95 CI 1.793 - 13.906). Only 14.4 and 41.7 reported any burden on their daily life before and during pregnancy; respectively. Previous vaginal delivery (P = 0.01; OR 3.12; 95 CI 2.91-5.62); grand-multiparity (P = 0.04; OR 4.15; 95 CI 3.82-7.24) were associated with LUTS prior to pregnancy while presence of LUTS before pregnancy (P = 0.001; OR 10.80; 95 CI 4.24-27.52); previous vaginal delivery (P = 0.002; OR 6.38; 95 CI 4.25-12.43) and moderate maternal obesity (P = 0.03; OR 2.56; 95 CI 1.82-3.47) were predictive of LUTS during pregnancy. Conclusion: LUTS are common among women both before and during pregnancy but most of them were not bothered by the LUTS. Those with previous vaginal delivery and are grand-multiparous are more likely to develop LUTS prior to pregnancy while the presence of LUTS before pregnancy; vaginal delivery and maternal obesity are determinants of LUTS during pregnancy

Total abdominal hysterectomy for benign gynaecological conditions at a University Teaching Hospital in Nigeria.

BACKGROUND: Hysterectomy is one of the most commonly performed major gynaecological procedures in women. Total abdominal hysterectomy (TAH) for benign disorders is commonly performed in Jos University Teaching Hospital and this study aimed at ascertaining its frequency in relation to other major gynaecological operations, demographic features of the patients, indications and safety of the procedure in this institution. MATERIALS AND METHODS: A retrospective descriptive study of consecutive patients who had elective total abdominal hysterectomy performed for various benign indications during the study period from January 2001 to December 2008 was conducted. Data extracted from the case files included age, parity, presenting symptoms, indications for the surgery, intraoperative findings and post-operative complications. Data was analysed with 2008 EPI-info version 3.5.1. RESULTS: Total abdominal hysterectomy accounted for 18.2% of all major gynaecological operations. Majority of the women were in their fifth decade of life (65.9%) and parity of five and above (46.4%). The most common indications were uterine fibroid with or without menorrhagia (60.6%) and cervical intraepithelial neoplasia (27.0%). Post-operative morbidity was recorded in 40 (17.7%) of cases. Post-operative wound infection (52.5%) and fever (30.0%) accounted for the majority of the complications. There was no mortality. CONCLUSIONS: Total abdominal hysterectomy for benign conditions is relatively common and safe in this centre. The review of the antibiotic regimes for chemoprophylaxis may help in reducing the post-operative infection rate associated with the operation.