TITLE:
Effects of Pregnancy and Delivery in Women with Previous Surgery for Stress Urinary Incontinence with Suburethral Band: A Bibliographic Review
AUTHORS:
Natalia Gennaro Della Rossa, Maria Victoria Herranz Izquierdo, Myriam Gracia Segovia, Francisco Javier Plaza Arranz
KEYWORDS:
Stress Urinary Incontinence, Pregnant, Suburethral Band, TOT, TVT
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.15,
December
16,
2015
ABSTRACT: The continence status and the most adequate form of delivery were
assessed in pregnant women who had a suburethral band to treat stress urinary
incontinence (SUI). A group of 57 women selected from different articles
published between 2000 and 2014 were reviewed. These women had become pregnant
after having undergone a suburethral band procedure. Different aspects such as
age, parity, type of band, time elapsed between the procedure and the
pregnancy, SUI during pregnancy and after delivery, and the form of delivery
were evaluated, as well as the possible relationship with the recurrence of SUI
and the emergence of complications associated with the suburethral during
pregnancy. A case of a complication related to a suburethral band was found in
one patient who developed an episode of pyelonephritis and intermittent
urethral obstruction which required a Foley catheter. Thirty patients had
cesarean section while 27 had vaginal deliveries; 12 patients had incontinence
during pregnancy and 15 suffered from it after delivery. Postpartum SUI in
relation with the delivery form did not show statistically relevant differences
between the cesarean section group and the vaginal delivery group. It was
observed that the emergence of SUI during pregnancy was a risk factor for the
onset of postpartum SUI (OR = 6.47; p = 0.0137). The risk of developing
postpartum SUI seems similar regardless the delivery form, thus it is plausible
to recommend vaginal delivery to these patients. If there was a recurrence of
SUI, a second suburethral band could be placed which would be as effective as
the first one and would involve a lower risk surgery compared to a cesarean
section.