Pregnancy following incontinence surgery

Area of Science:

• Urogynecology
• Obstetrics
• Female Pelvic Medicine

Background:

• Continence surgery is frequently performed in women of childbearing potential.
• Patient desire for future childbearing presents a complex clinical scenario.
• Surgical recommendations and delivery outcomes require further investigation.

Purpose of the Study:

• To assess current practices regarding continence surgery in women desiring future childbearing.
• To evaluate the impact of delivery mode on postpartum continence status after prior incontinence surgery.

Main Methods:

• A questionnaire was distributed to 304 members of the American Urogynecology Society.
• Data collected included surgical procedures recommended, delivery preferences, and postpartum continence status.
• Fisher's exact test was used for statistical analysis.

Main Results:

• 99 of 149 respondents had performed continence surgery on patients desiring future childbearing.
• Burch colposuspension was the most recommended procedure (111), followed by sling procedures (29).
• Postpartum continence was significantly lower after vaginal delivery (73%) compared to cesarean section (95%) (P = 0.0344).

Conclusions:

• Continence surgery recommendations vary, with Burch colposuspension being most common.
• Delivery mode significantly impacts postpartum continence in women who have undergone prior incontinence surgery.
• Cesarean section appears to preserve continence more effectively than vaginal delivery in this population.