title: Pregnancy management in women within the bladder-exstrophy-epispadias complex (BEEC) after continent urinary diversion.
abstract: BACKGROUND
  Management of operative delivery in pregnant women after reconstruction of the bladder-exstrophy-epispadias complex (BEEC) using bowel segments remains a challenge.
  
  
  METHODS
  We report urological history, pregnancy and delivery course of two BEEC patients after previous abdominal bowel surgeries. One had an ileocecal pouch after previously failed reconstruction, and the other had an ileum augmentation and a catheterizable Mitrofanoff stoma after functional reconstruction of the exstrophic bladder.
  
  
  RESULTS
  Frequent bacteriuria and hydronephrosis warranted low-dose prophylaxis throughout pregnancy in one female, bilateral mild upper tract dilatation sonographic monitoring in both patients. Both were successfully delivered by cesarean section. No complications or clinical and sonographic signs for prolapse occurred. However, our operative experience revealed the importance of the abdominal incision type after different reconstructed reservoirs.
  
  
  CONCLUSIONS
  Though care should be intense in pregnant BEEC individuals, patients should not be discouraged to have own children. To facilitate successful pregnancy outcome operative delivery should be done as a interdisciplinary team work and emergency situations should be avoided by meticulous planning and counseling of the BEEC patients.
authors.affiliation: Department of Pediatric Urology, University Medical Center Regensburg, Klinik St. Hedwig, Steinmetzstr. 1-3, 93049 Regensburg, Germany. anne-karoline.ebert@barmherzige-regensburg.de
authors.forename: Anne K
authors.initials: AK
authors.lastname: Ebert
authors.forename: Andreas
authors.initials: A
authors.lastname: Falkert
authors.forename: Andrea
authors.initials: A
authors.lastname: Hofstädter
authors.forename: Heiko
authors.initials: H
authors.lastname: Reutter
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Rösch
mesh_terms: D000293:Adolescent; D000328:Adult; D001746:Bladder Exstrophy / Q000601:surgery*; D036861:Delivery, Obstetric; D003937:Diagnosis, Differential; D004842:Epispadias / Q000601:surgery*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D016476:Urinary Reservoirs, Continent; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy