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Related Experiment Videos

[Pregnancy after augmentation cystoplasty. A case report]

Y Yamazaki1, R Yago, H Toma

  • 1Department of Urology, Tokyo Women's Medical College.

Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
|June 1, 1997
PubMed
Summary

Pregnancy after ileocystoplasty for neurogenic bladder presents risks like urinary tract infections and hydronephrosis. Prophylactic antibiotics and careful surgical planning are crucial for managing these complications.

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Area of Science:

  • Urology
  • Obstetrics
  • Gastroenterology

Background:

  • Ileocystoplasty is a surgical procedure to create a new bladder from a segment of the ileum, often for neurogenic bladder.
  • Pregnancy following ileocystoplasty presents unique challenges due to altered anatomy and potential complications.

Observation:

  • A 31-year-old woman with spina bifida occulta experienced recurrent febrile urinary tract infections and hydronephrosis during pregnancy after ileocystoplasty.
  • Severe pyelonephritis at 25 weeks gestation necessitated ureteral stent placement, which led to persistent bacteriuria.
  • Cesarean section at 32 weeks revealed adhesions between the neobladder, mesenteric blood supply, and the uterus.

Findings:

  • Urinary tract infections are common in pregnant patients with a history of enterocystoplasty.

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  • Ureteral stents may have questionable long-term efficacy and can lead to catheter-associated bacteriuria.
  • Adhesions of the neobladder and its vascular supply to the uterus pose risks during cesarean delivery.

    • Implications:

    • Prophylactic antibiotics throughout pregnancy are essential for patients who have undergone enterocystoplasty.
    • A reconstructive urological surgeon should be involved in cesarean sections to prevent injury to the cystoplasty's blood supply.
    • Careful management and multidisciplinary collaboration are vital for successful pregnancy outcomes in these complex cases.