From the Division of Female Pelvic Medicine and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Female Pelvic Med Reconstr Surg. 2020 Jan/Feb;26(1):e4-e6. doi: 10.1097/SPV.0000000000000774.
There are limited data on the management of pregnancy and delivery after midurethral sling (MUS) surgery for stress urinary incontinence (SUI). We report a case of a 39-year-old woman who underwent an MUS in July 2017. She reported a 10-year history of frequency, urgency with rare urge incontinence, nocturia, and occasional SUI when coughing or sneezing. Preoperative assessment did not include a pregnancy test. Two days after MUS placement, she developed complete urinary retention, and it was determined that she was 6 weeks pregnant. She was referred to a tertiary urogynecology unit and was seen at 23 weeks' gestation with worsening symptoms of urinary frequency and nocturia. She also described difficulty voiding but no incontinence. She was managed with conservative measures initially, but by 35 weeks, she required intermittent self-catherization (ISC). She underwent an elective cesarean delivery at 39 weeks' gestation. She reported postvoid dribbling, urge incontinence, and recurrent SUI at 10 months postpartum. This case report adds to the body of knowledge around outcomes of MUS during and after pregnancy.
关于压力性尿失禁（SUI）患者行中尿道吊带（MUS）手术后的妊娠和分娩管理，目前数据有限。我们报告了 1 例 39 岁女性病例，她于 2017 年 7 月接受 MUS 手术。她诉有 10 年频尿、尿急（偶有急迫性尿失禁）、夜尿和偶发咳嗽或打喷嚏时的 SUI。术前评估未包括妊娠试验。MUS 放置后 2 天，她出现完全性尿潴留，经确定她已怀孕 6 周。她被转诊至三级泌尿妇科单位，并在妊娠 23 周时就诊，症状为尿频和夜尿加重。她还描述了排尿困难，但无尿失禁。她最初接受保守治疗，但在 35 周时需要间歇性自我导尿（ISC）。她在妊娠 39 周时行择期剖宫产。她在产后 10 个月时报告有排尿后滴沥、急迫性尿失禁和复发性 SUI。本病例报告增加了 MUS 在妊娠期间和之后的结果方面的知识体系。
