Factors Influencing Pelvic Floor Function Recovery in Postpartum Stress Urinary Incontinence Patients and Development of a Nomogram: A Retrospective Cohort Study with Focus on Magnetic and Electrical Stimulation Therapy

Abstract

Objective

To identify determinants of pelvic floor recovery in postpartum stress urinary incontinence (PP-SUI) and develop a nomogram for predicting poor recovery, focusing on magnetic and electrical stimulation therapies.

Methods

This retrospective cohort study included 712 women with urodynamically confirmed PP-SUI who underwent 4 weeks of pelvic floor rehabilitation. Patients were randomly divided into a training cohort (n = 499) and a validation cohort (n = 213). Logistic regression identified independent predictors, and a nomogram was constructed and evaluated using ROC curves, calibration plots, and decision curve analysis (DCA).

Results

At 3 months, 38.48% of patients showed poor recovery. Independent risk factors included older maternal age (OR = 1.09), absence of magnetic stimulation (OR = 0.61), absence of electrical stimulation (OR = 0.68), labor analgesia (OR = 1.86), episiotomy (OR = 3.32), gestational SUI (OR = 1.83), and higher neonatal birth weight (OR = 1.24). The nomogram demonstrated good discrimination (AUC: 0.728 training; 0.774 validation) and calibration (Hosmer–Lemeshow P > 0.05). DCA indicated clinical utility. Risk stratification showed increased odds of dysfunction in medium- (OR = 1.79) and high-risk groups (OR = 3.89).

Conclusion

Several clinical factors significantly influence pelvic floor recovery after PP-SUI. The proposed nomogram provides a practical tool for individualized risk assessment and may support targeted rehabilitation strategies.

Keywords

Postpartum stress urinary incontinence pelvic floor dysfunction nomogram magnetic stimulation electrical stimulation logistic regression

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