Intended for healthcare professionals

Rapid response to:


Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: six year follow up

BMJ 2005; 330 doi: (Published 10 February 2005) Cite this as: BMJ 2005;330:337

Rapid Response:

Conservative management of postnatal incontinenece

Dear sir This study highlighted the existing cochrane data information about using conservative treatment for postnatal incontinenece.As we are aware that there are not only longterm physical but also social & psychological problems associated with incontinence.

The risk of sphincter injury is increased at first delivery , forceps delivery, fetal birth-weight greater than 4,000 g and prolonged second stage of labour, occipito-posterior position, and midline episiotomy.

Injury can be prevented or minimized by appropriate training for the instrumental deliveries, optimizing perineal repair technique, and by appropriate postnatal assessment of symptomatic women. The dictum that`Prevention is better than cure` still stands.

Competing interests: None declared

Competing interests: No competing interests

12 February 2005
Ramesh Appiahanna
SHO in O&G
Goerge Eliot hospital, Nuneaton,CV10 7DJ