Delivery after augmentation cystoplasty: Implications and precautions.

Area of Science:

• Urology
• Obstetrics & Gynecology
• Reproductive Medicine

Background:

• Augmentation cystoplasty (AC) is a complex reconstructive surgery for bladder augmentation.
• Pregnancy following AC presents unique challenges, particularly in patients with a solitary functioning kidney and a history of genitourinary tuberculosis.
• Management requires multidisciplinary collaboration between urologists and gynecologists.

Observation:

• A young female with a solitary kidney and prior AC underwent a successful pregnancy.
• She experienced two febrile urinary tract infections during gestation, with preserved renal function.
• Lower segment cesarean section was performed despite significant pelvic anatomical alterations.

Findings:

• Pregnancy is achievable in select patients post-AC with a solitary kidney.
• Close monitoring for urinary tract infections and renal function is crucial throughout gestation.
• Successful delivery via cesarean section is feasible in cases with altered pelvic anatomy.

Implications:

• This case underscores the importance of a multidisciplinary approach for managing pregnancy in women with augmented bladders.
• Anticipating and proactively managing potential complications, such as UTIs and delivery challenges, is vital.
• Further literature review is needed to establish best practices for urologists and gynecologists managing these rare pregnancies.