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Pregnancy and delivery after mid-urethral sling operation
Sari A Tulokas1, Päivi Rahkola-Soisalo2, Mika Gissler3,4
1Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, PO Box 140, FI-00029, Helsinki, HUS, Finland. sari.tulokas@helsinki.fi.
International Urogynecology Journal
|August 26, 2020
Summary
Pregnancy following mid-urethral sling (MUS) surgery does not increase the risk of stress urinary incontinence (SUI) re-procedure or re-visits. Therefore, future pregnancy should not be considered a contraindication for MUS operations.
Area of Science:
- Urology
- Gynecology
- Female Pelvic Medicine
Background:
- Mid-urethral sling (MUS) operations are common for stress urinary incontinence (SUI).
- There is no consensus on managing pregnancy after MUS, with some recommending delayed surgery or cesarean delivery.
- This study investigates the impact of pregnancy on SUI recurrence and complications post-MUS.
Purpose of the Study:
- To assess the risk of SUI re-procedure after delivery in women who previously underwent MUS surgery.
- To analyze SUI re-visits and MUS-related complications during pregnancy and postpartum periods.
Main Methods:
- A register-based case-control study was conducted in Finland (1996-2016).
- 94 women with a subsequent pregnancy after MUS were compared to 330 age-, operation type-, and year-matched controls without subsequent pregnancies.
- Follow-up duration was a median of 10.7 years.
Main Results:
- No significant difference in SUI re-procedures was observed between women who had pregnancies after MUS (3.2%) and controls (5.2%).
- Re-visits for SUI or mixed urinary incontinence did not differ significantly (24.5% vs. 26.1%), though some occurred before delivery.
- The rate of vaginal delivery was lower after MUS (57%) compared to pre-MUS deliveries (91%).
Conclusions:
- Pregnancy following MUS surgery does not elevate the likelihood of SUI re-procedure or re-visits.
- Future pregnancies should not be considered an absolute contraindication for undergoing MUS operations.
- MUS surgery appears safe concerning SUI recurrence in women who subsequently become pregnant.
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