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Pregnancy and delivery after mid-urethral sling procedures for stress urinary incontinence: case reports and a review of literature

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Abstract

In this article, the effects of pregnancy and delivery on the development of stress urinary incontinence are described with special emphasis on the obstetrical management in women who wish to become pregnant or are pregnant after a preceding mid-urethral sling procedure. Three case histories and a review of literature are presented. Pregnancy after a preceding incontinence operation is rare and makes it quite difficult to formulate guidelines about delivery when a pregnancy occurs. The best advice is to postpone incontinence surgery until after the last pregnancy. There is evidence that an elective caesarean delivery protects against stress urinary incontinence in case of pregnancy after bladder neck suspension. For mid-urethral sling procedures, this evidence is not available. The presented case reports do not clearly demonstrate that caesarean delivery is necessary in case of pregnancy and delivery after a mid-urethral sling procedure. Furthermore, a second mid-urethral sling operation is a minor procedure compared to a caesarean section, and there is evidence that a second mid-urethral sling operation has the same success rate as the first procedure.

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Acknowledgments

We thank Dr Dorette Courtar of University Hospital Maastricht for the synopsis of pregnancy and labor of the third patient.

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None.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, St. Elisabeth Hospital, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands

    Rian Groenen, M. Caroline Vos & Harry A. M. Vervest

  2. Department of Gynecology and Obstetrics, University Medical Center, Maastricht, The Netherlands

    Christine Willekes

Authors
  1. Rian Groenen
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  2. M. Caroline Vos
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  3. Christine Willekes
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  4. Harry A. M. Vervest
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Correspondence to Rian Groenen.

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Groenen, R., Vos, M.C., Willekes, C. et al. Pregnancy and delivery after mid-urethral sling procedures for stress urinary incontinence: case reports and a review of literature. Int Urogynecol J 19, 441–448 (2008). https://doi.org/10.1007/s00192-007-0509-3

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  • DOI: https://doi.org/10.1007/s00192-007-0509-3

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