الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Labor is the results of conception that have been able to live outside the womb through several processes such as the thinning and opening of the cervix and the presence of contractions that take place at certain times without complications (Mitra & Kediri, 2020). Labor is defined as regular uterine contractions that cause cervical dilation and effacement, leading to delivery of the fetus and the products of conception (Ehsanipoor & Satin, 2020).Lots of women prefer cesarean delivery especially when there is maternal or fetal problems (Hatamleh et al., 2019). Cesarean section is now the most generally performed surgery in the world. There has been a dramatic increase of the cesarean rate around the world, which presently exceeds 30%. In Egypt, cesarean birth rate has been raised dramatically from 27.6%, in 2010 to 55% in 2016 (Al-Rifai and Aziz, 2018).Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus. It is indicated in some cases of malpresentations abnormal lie (Hofmeyr et al., 2019), also some case of twin pregnancy, special medical conditions would be contraindicated for vaginal delivery, fetal compromise (Gaudernack et al., 2020). Placenta previa, as well as in women with transmissible infections such as HIV/AIDS (Adewuyi et al., 2019).Martin et al. (2018) added previous (major shoulder dystocia, 3rd/4th degree perineal tear) and maternal choice.
Dysfunctional voiding is an abnormality of bladder emptying in neurologically normal individuals in which there is increased activity of external sphincter during voluntary voiding. Its symptoms may include the muscles that control the flow of urine out of the body don’t relax completely, the bladder never fully empties, a feeling that the bladder is always full urgency, straining to urinate, urinary tract infection, frequent urination, pain, hesitancy, dribbling, intermittent urine flow, pain in the back, flank, or abdomen (Avondstondt et al., 2020).
The main purpose of the current study is to compare of voiding dysfunction between women following vaginal and cesarean section delivery and to identify the factors that leads to post-partum voiding dysfunction.
The present study was carried out at Obstetric &Gynecological department, Menoufia University Hospital in Shebin El-kom.
A descriptive correlational design was used to compare of voiding dysfunction between women following vaginal and cesarean section delivery and to identify the factors that leads to post-partum voiding dysfunction.
The target populations of this study are women who fulfilling the inclusion criteria which included all full term (> 36 weeks) women who underwent for vaginal or cesarean delivery.
The sample size of this study was 200 women (100 women who had vaginal and 100 women who had caesarian section) who delivered at Obstetric
&Gynecological department, Menoufia University Hospital in Shebin El-kom.
Throughout the course of the present study; data were collected using interviewing questionnaire. The questionnaire included four main parts.
Part I- Demographic characteristics and Obstetric history: -
The demographic data included variables such as age, educational level, occupation, telephone number and marital status. The obstetric history included variables such as number of pregnancies, number of living children, mode of delivery (spontaneous vaginal delivery, cesarean section delivery), complications at delivery, gender and condition of newborn (male or female, alive or dead), fetal or maternal complications in the puerperium and time of last delivery.
Part II: -Medical and Surgical History:
This part was designed to assess the medical and surgical history of the women in the sample. Such as history of chronic disease and previous surgical operation.
Part III: -Risk factors assessment of voiding dysfunction:
This part included questions such as, type of anesthesia, use of fundal pressure during the second stage of labor, prolonged second stage of labor, delivery of macrosomic newborn, perineal laceration as well as episiotomy and injury to the bladder during the delivery.
Part IV: Voiding dysfunction assessment: -
This part consisted of closed ended questions to assess voiding dysfunction after delivery. It included closed ended questions such as number of voiding times per day, whether the woman had stress incontinence, if she had urgency, if there was any Straining during urination, if she had dysuria, if there was any intermittent urine flow, and if there was back pain, flank, or abdominal pain.
Approaches to ensure ethical issues were considered in the study.
Confidentiality was achieved by the use of locked sheets with the name of participants replaced by numbers. All participants were informed that the information they provided during the study would be kept confidential and used only for statistical purpose and after finishing the study, the findings would be presented as a group data with no personal participant’s information remained.
The current study showed that more than half of the women following cesarean section delivery complained of continuous UTI while only less than half of the women who delivered vaginally complained of continuous UTI.This may be due to use of analgesia significantly affects bladder care also catheterization increasing the incidence of UTI.
The present study also revealed that women who delivered vaginally were more prone to have voiding dysfunction problems than cesarean section delivery as more than one third of the women who delivered vaginally had voiding dysfunction while only one fifth of the women who delivered CS.
The current study also showed that factors that leaded to post-partum voiding between women following vaginal delivery and CS included mostly the use of fundal pressure during the second stage of labor, rupture of the perineum occur during childbirth, and insertion of urinary catheter during delivery.
This study revealed that women with previous vaginal delivery tended to urinate slowly after delivery with hesitancy than women with previous Cs also voiding dysfunction was found to be higher in primiparity than multiparty women.
Also most of women in the two groups aged between twenty to less than thirty years and educational level had an effect on symptoms of voiding dysfunction of the studied groups regarding time of urination after delivery only.
This means the current study succeeded in answering research questions.