title: Effect of pregnancy and delivery on urinary incontinence after the midurethral sling procedure.
abstract: OBJECTIVE
  To evaluate the continence status and to reveal the optimal delivery mode of women who had an infant after application of a midurethral sling to treat stress urinary incontinence.
  
  
  METHODS
  Between January 2007 and January 2013, 12 women who delivered an infant after application of a midurethral sling were detected and demographic data, type of MUS, interval between MUS and delivery, mode of delivery, birth weight of the newborn, complications during pregnancy, and continence status after delivery were collected. Between 2000 and 2014, in 14 articles listed in Pubmed, the data of 54 patients who had delivered after successful midurethral sling application were included. Postpartum recurrence of urinary incontinence was evaluated according to delivery type in 54 patients.
  
  
  RESULTS
  Mean age of 12 patients at the time of MUS was 33.1 ± 4.3 years old and the interval between MUS procedure and pregnancy was 30.2 ± 14.2 months. Four patients had a transvaginal tape (TVT; 33.3%) and 8 had transobturator tape (TOT) procedure (66.7%) and mean follow-up after MUS surgery was 52 ± 12.3 months. Seven women had cesarean section (CS; 58.3%) and 5 women delivered vaginally (41.7%). Nine women were continent during pregnancy (75%) and 10 were continent after delivery (83.3%). Among 54 women who were included in the review, 28 underwent CS (51.9%), 26 women delivered vaginally (48.1%), and 11 women had postpartum incontinence (20.3%). In the case of postpartum urinary incontinence, there was no statistically significant difference between the CS and vaginal delivery groups (14.3 vs 26.9% respectively, p = 0.32). In logistic regression, incontinence during pregnancy was a risk factor for postpartum incontinence (OR:5.5; 95% CI: 1.1-27.6, p = 0.036).
  
  
  CONCLUSIONS
  Risk of postpartum SUI recurrence in women who underwent application of midurethral slings seems to be similar independent of delivery mode and incontinence during pregnancy may be a risk factor for postpartum incontinence.
authors.affiliation: Department of Obstetrics and Gynecology, Ankara Zekai Tahir Burak Woman's Health Research and Education Hospital, Gurpinar sokak. No: 4/8 Cebeci, Ankara, Turkey, sabri.cavkaytar@gmail.com.
authors.forename: Sabri
authors.initials: S
authors.lastname: Cavkaytar
authors.forename: Mahmut Kuntay
authors.initials: MK
authors.lastname: Kokanali
authors.forename: Irfan
authors.initials: I
authors.lastname: Ozer
authors.forename: Selcuk
authors.initials: S
authors.lastname: Erkilinc
authors.forename: Orhan Seyfi
authors.initials: OS
authors.lastname: Aksakal
authors.forename: Melike
authors.initials: M
authors.lastname: Doganay
mesh_terms: D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012008:Recurrence; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000601:surgery