Related Experiment Videos
Pregnancy after orthotopic continent urinary diversion
W A Kennedy1, T W Hensle, E A Reiley
1Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York.
Surgery, Gynecology & Obstetrics
|October 1, 1993
Summary
Female patients with bladder exstrophy who underwent continent urinary diversion, specifically the Indiana pouch, can achieve successful pregnancies. While complications like UTIs and hydronephrosis occurred, outcomes were positive for both mothers and infants, with cesarean delivery recommended.
Area of Science:
- Urology
- Reproductive Medicine
- Pediatric Surgery
Background:
- Continent urinary diversion is a common bladder management strategy for female exstrophy patients with failed primary reconstruction.
- Flap vaginoplasty and continent urinary reservoirs (Indiana pouch) are part of the management for these patients.
Purpose of the Study:
- To report on the outcomes of pregnancies in young adult females with a history of continent urinary diversion (Indiana pouch).
- To evaluate the safety and feasibility of pregnancy in this patient population.
Main Methods:
- Case series reporting on four young adult females with Indiana pouch urinary diversion who became pregnant.
- Monitoring of maternal urinary tract infections, cervical prolapse, hydronephrosis, and catheterization challenges.
- Assessment of delivery methods and infant outcomes.
Main Results:
- All four patients experienced successful pregnancies, delivering healthy infants via cesarean section.
- Complications included urinary tract infections, cervical prolapse, and maternal hydronephrosis.
- Maternal hydronephrosis resolved post-delivery; cervical prolapse persisted in three patients.
- Clean intermittent catheterization was manageable post-delivery for all patients.
Conclusions:
- Orthotopic continent urinary diversion (Indiana pouch) is not a contraindication to pregnancy.
- Pregnancy in these patients requires careful monitoring for maternal and fetal distress.
- Cesarean section delivery is recommended for all pregnancies following Indiana pouch urinary diversion.