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Pregnancy complicated by a suburethral sling: a case report
C M Lynch1, A K Powers, A B Keating
1Department of Obstetrics and Gynecology, University of South Florida, College of Medicine, Tampa, USA. clynch@com1.med.usf.edu
Summary
Pregnancy after incontinence surgery, specifically a suburethral sling, can lead to complications. This case highlights risks like urinary obstruction, pyelonephritis, and surgical repair disruption in pregnant women with prior sling procedures.
Area of Science:
- Urogynecology
- Maternal-Fetal Medicine
Background:
- Incontinence surgery is infrequently performed before childbearing is complete.
- Limited literature exists on pregnancy outcomes following prior incontinence surgery.
- No prior reports document pregnancy complicated by a suburethral sling procedure.
Observation:
- A 26-year-old woman, gravida 3, para 2-0-0-2, with a history of Pereyra urethropexy and Vesica suburethral sling, presented at 18 weeks' gestation.
- Her pregnancy was complicated by pyelonephritis and intermittent urethral obstruction necessitating Foley catheterization.
- Delivery occurred via scheduled cesarean section at 37 weeks' gestation.
Findings:
- Postpartum, the patient experienced recurrent pyelonephritis and incontinence.
- Pregnancy in conjunction with a prior suburethral sling procedure can precipitate urinary outlet obstruction.
- Complications include pyelonephritis and potential disruption of the incontinence surgical repair.
Implications:
- This case underscores the potential risks of pregnancy following suburethral sling placement.
- Clinicians should be aware of the possibility of urinary outlet obstruction and pyelonephritis in such pregnancies.
- Careful antenatal surveillance and management are crucial for pregnant women with a history of incontinence surgery.