Pregnancy and delivery after mid-urethral sling operation
| Autor: | Sari Tulokas, Päivi Rahkola-Soisalo, Tomi S. Mikkola, Mika Gissler, Maarit Mentula |
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| Přispěvatelé: | Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital Area, HUS Gynecology and Obstetrics, Clinicum |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
SURGERY Urinary Incontinence Stress Urology Urinary incontinence Mid-Urethral Sling TVT Mesh tape 03 medical and health sciences 0302 clinical medicine 3123 Gynaecology and paediatrics Pregnancy medicine Humans 030212 general & internal medicine TVT-O Contraindication Finland Suburethral Slings COMPLICATIONS Mixed urinary incontinence 030219 obstetrics & reproductive medicine Stress urinary incontinence Cesarean Section Obstetrics Vaginal delivery business.industry Significant difference Obstetrics and Gynecology medicine.disease STRESS URINARY-INCONTINENCE 3. Good health TOT Case-Control Studies Urologic Surgical Procedures Original Article Female medicine.symptom Subsequent pregnancy business Mid-urethral sling |
| Zdroj: | International Urogynecology Journal |
| ISSN: | 1433-3023 0937-3462 |
| Popis: | Introduction and hypotheses There is no consensus regarding pregnancy after mid-urethral sling (MUS) operation, and some clinicians recommend postponing the MUS operation if a woman considers further pregnancies or routinely suggest cesarean section as the delivery method after MUS operations. Our primary aim was to assess the risk for stress urinary incontinence (SUI) re-procedure after delivery in women with a MUS operation prior to pregnancy. We also analyzed SUI re-visits and MUS-related complications during pregnancy and postpartum. Methods We conducted a register-based case-control study of women with a MUS operation in Finland during 1996–2016. We identified 94 cases with a subsequent pregnancy and 330 controls without subsequent pregnancies matched by age, operation type and year. Results The median follow-up time was 10.7 years (IQR 7.1–13.7). The number of SUI re-procedures did not differ between the cases (n = 3, 3.2%) and controls (n = 17, 5.2%; OR 0.6, 95% CI 0.2–2.1). There was no significant difference in re-visits for stress or mixed urinary incontinence between the cases (n = 23, 24.5%) and controls (n = 86, 26.1%; OR 0.9, 95% CI 0.5–1.6), but 35% of the re-visits in the case group occurred already before the delivery after MUS. The rate of vaginal delivery was lower after MUS operation (57%) than in deliveries before MUS (91%, P Conclusions Pregnancy after MUS did not increase the odds for SUI re-procedure or re-visit. Considering on our results, future pregnancy does not need to be viewed as an absolute contraindication for MUS operation. |
| Databáze: | OpenAIRE |
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