OBJECTIVE: To realize a review of literature to observe the impact of pregnancy and delivery in patients who underwent mid-urethral sling procedure for stress urinary incontinence (SUI), in order to provide recommendations on the route of delivery.
MATERIAL AND METHODS: Literature review from 1995 to 2012 on the database Pubmed/Medline including only studies involving pregnant women with mid-urethral sling procedure.
RESULTS: Of the 35 published cases, 14 % of patients had a recurrence of SUI symptoms during pregnancy. Nineteen percent of patients who underwent a c-section had SUI symptoms in the immediate postpartum period, against 33 % of patients with vaginal deliveries (P=0.56). In the follow-up of delivery (>3 months), there was a persistent SUI in 20 % (7/34) of patients: 12.5 % (2/16) of women who underwent a c-section and 27.7 % (5/18) of women who had a vaginal delivery (P=0.75).
CONCLUSION: Although c-section seems to slightly decrease the risk of recurrence of SUI comparing to the vaginal route, we do not recommend to propose a systematic elective c-section in these patients because of its morbidity and mortality and the possibility of repeat mid-urethral sling procedure.
Written by:
Demoulin G, Thubert T, Faivre E, Trichot C, Deffieux X. Are you the author?
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; Service de gynécologie-obstétrique et médecine de la reproduction, CHR de Metz-Thionville, 57045 Metz cedex 01, France.
Reference: J Gynecol Obstet Biol Reprod (Paris). 2012 Nov 22. pii: S0368-2315(12)00327-4.
doi: 10.1016/j.jgyn.2012.10.004
PubMed Abstract
PMID: 23182788
Article in French.
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