International Urogynecology Journal

, Volume 19, Issue 3, pp 441–448 | Cite as

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

  • Rian GroenenEmail author
  • M. Caroline Vos
  • Christine Willekes
  • Harry A. M. Vervest


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.


Stress urinary incontinence Pregnancy Delivery 



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

Conflicts of interest



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Copyright information

© International Urogynecology Journal 2007

Authors and Affiliations

  • Rian Groenen
    • 1
    Email author
  • M. Caroline Vos
    • 1
  • Christine Willekes
    • 2
  • Harry A. M. Vervest
    • 1
  1. 1.Department of Gynecology and ObstetricsSt. Elisabeth HospitalTilburgThe Netherlands
  2. 2.Department of Gynecology and ObstetricsUniversity Medical CenterMaastrichtThe Netherlands

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