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Re: First vaginal delivery at an older age: Does it carry an extra risk for the development of stress urinary incontinence? Groutz A, Helpman L, Gold R, Pauzner D, Lessing JB, Gordon D. 2007. Neurourol Urodyn 26:779–782

The conclusions of Groutz et al must be interpreted with extreme prudence. An accurate response to the two questions asked by the authors would require to compare, in a cohort of young women of the same age before their first pregnancy, the prevalence of SUI several years later (at the same age for all the women) as a function of parity, age at first delivery and mode of delivery and to analyse, in a randomised trial (elective cesarean versus vaginal delivery) the effect of cesarean according to the woman’s age.