Schumacher S, Fichtner J, Stein R, Wiedemann A, Hohenfellner R
Department of Urology, Medical School Mainz and Marienhospital Gelsenkirchen, Germany.
J Urol. 1997 Oct;158(4):1362-4.
We report on our experience with pregnancies and deliveries in patients with a continent ileocecal reservoir with catheterizable stoma (Mainz pouch).
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.
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.
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.
我们报告了采用可控性回盲肠膀胱术（美因茨袋）的患者妊娠和分娩的经验。
6名年龄在18至33岁（平均年龄26.8岁）的女性在接受尿流改道术后怀孕。构建了一个包含5个脐部造口和1个左下腹象限造口的可控性回盲肠膀胱术。基础疾病包括4例膀胱外翻、1例脊髓脊膜膨出和另1例泌尿生殖窦畸形。所有患者均由产科医生和泌尿科医生联合进行剖宫产。
6名女性共发生7次妊娠。3次妊娠完全顺利。妊娠并发症包括4例输尿管扩张伴肾盂肾炎和1例早产。左下腹象限造口患者的乳头脱垂在剖宫产时很容易得到纠正。所有患者均顺利进行了剖宫产。共分娩出7名健康婴儿。
对于采用美因茨袋尿流改道的女性，妊娠似乎没有禁忌证，而其他形式的可控性尿流改道有待进一步评估。泌尿科医生和产科医生应意识到这种高危妊娠和分娩的潜在并发症，他们的跨学科合作对于取得成功结局至关重要。
