Pregnancy and delivery following midurethral sling surgery for stress urinary incontinence.
OBJECTIVE
To analyze the available clinical evidence on the continued effectiveness of midurethral sling (MUS) surgery for stress urinary incontinence (SUI) in women who become pregnant and undergo delivery, and then to determine the optimal mode of delivery for such women.


METHODS
An online search was carried out to retrieve the available evidence regarding the risk of SUI recurrence during pregnancy and after delivery following a successful MUS treatment. Appropriate keywords were used to identify all relevant reports published from 1996 through 2011. Basic patient characteristics, mode of delivery, and presence of SUI during pregnancy and the postpartum were analyzed.


RESULTS
No more than 36 relevant cases were found. The overall urinary continence rates were 91.7% during pregnancy and 80.6% during the postpartum. Most (58.3%) of the women were delivered vaginally.


CONCLUSIONS
The evidence indicates that the risk of SUI recurrence is not significantly different after a vaginal or a cesarean delivery. In women successfully treated with a MUS, pregnancy care and delivery mode therefore need to be considered case by case, according to factors other than the risk of recurrence.
Department of Obstetrics and Gynecology, Brno University Hospital, Masaryk University School of Medicine, Brno, Czech Republic. martin.huser@gmail.com
Martin
M
Huser
Ivan A
IA
Belkov
Petr
P
Janku
Katerina
K
Sedlakova
D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012008:Recurrence; D012306:Risk; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000601:surgery*