Pregnancy after Mainz pouch urinary diversion.

PURPOSE

We report on our experience with pregnancies and deliveries in patients with a continent ileocecal reservoir with catheterizable stoma (Mainz pouch).

MATERIALS AND METHODS

Six women aged 18 to 33 years (mean age 26.8 years) became pregnant after undergoing urinary diversion. A continent ileocecal reservoir was made comprising 5 umbilical stomas and 1 stoma in the left lower abdominal quadrant. Underlying diseases were bladder exstrophy in 4, meningomyelocele in 1 and urogenital sinus in another patient. Cesarean section was jointly performed by the obstetricians and urologists in all patients.

RESULTS

Seven pregnancies occurred in a total of 6 women. Three pregnancies were completely uneventful. Pregnancy complications were ureteral dilatation in 4 cases with pyelonephritis and premature labor in 1 case. A nipple prolapse in the patient with the stoma in the left lower abdominal quadrant was easily corrected during cesarean section. All patients underwent cesarean section without complications. Seven healthy children were born.

CONCLUSIONS

In women with Mainz pouch urinary diversion there appears to be no contraindication to pregnancy, while other forms of continent diversion await further evaluation. Urologists and obstetricians should be aware of the potential complications of this high risk pregnancy and delivery, and their interdisciplinary cooperation is essential for successful outcome.