Pregnancy in patients with the artificial urinary sphincter

Since 1974, 71 female patients between 3 and 25 years old have undergone implantation of the artificial urinary sphincter for treatment of urinary incontinence. Of these women 9 have become pregnant and delivered 11 normal children. In 2 women the artificial urinary sphincter was removed because of erosion before conceiving, while the remaining 7 had a functional artificial urinary sphincter in place at conception, and subsequent pregnancy and delivery. All 11 women had normal pregnancies and, aside from the normally increased frequency of urination and a slight increase in urinary leakage due to elevated pressure on the bladder from the adjacent uterus, the urinary continence was unchanged. Of the women 4 underwent cesarean section at the advice of their obstetricians and the remainder had uneventful vaginal deliveries. During the course of the pregnancies the patients or their obstetricians consulted 1 of us for advice regarding management of the delivery because of the presence of the artificial urinary sphincter. The normalcy of the pregnancies and deliveries led us to conclude that the presence of a functioning artificial urinary sphincter did not increase the risk of complications during pregnancy and childbearing.