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[Continent urinary diversion and pregnancy]

G E Voges1, L Orestano, S Schumacher

  • 1Urologische Klinik und Poliklinik der Johannes Gutenberg-Universität Mainz.

Geburtshilfe Und Frauenheilkunde
|December 1, 1995
PubMed
Summary

Pregnancy is safe after urinary diversion surgery, including continent reservoirs like the Mainz-Pouch I. Women experienced few complications, with all newborns healthy, indicating no contraindications for pregnancy.

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Area of Science:

  • Urology
  • Obstetrics & Gynecology
  • Reproductive Medicine

Context:

  • Urinary tract reconstruction with diversion (e.g., Mainz-Pouch I, ureterosigmoidostomy, bladder augmentation) is performed for various conditions.
  • Pregnancy following such reconstructive surgeries presents unique challenges for both mother and fetus.
  • Limited data exists on the outcomes of pregnancy in women with complex urinary diversions.

Purpose:

  • To evaluate the safety and outcomes of pregnancy in women who have undergone urinary tract reconstruction with diversion.
  • To assess complications, management strategies, and delivery modes in this patient population.
  • To determine if pregnancy is contraindicated after different types of urinary diversion.

Summary:

  • Seven pregnancies in six women with prior urinary diversion (Mainz-Pouch I, ureterosigmoidostomy, bladder augmentation) were analyzed.

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  • The main complications were urinary tract infections and upper tract dilatation, managed conservatively or with nephrostomies.
  • Continence mechanisms remained intact, and all seven newborns were healthy. Deliveries included vaginal and Cesarean sections.

    • Impact:

    • Pregnancy is feasible and generally safe after various urinary diversion procedures, including continent reservoirs.
    • Close, multidisciplinary urological and gynaecological monitoring is essential throughout pregnancy.
    • Obstetricians must be aware of the altered intra-abdominal anatomy, especially if Cesarean section is indicated.