Pregnancy after orthotopic continent urinary diversion

W. A. Kennedy, T. W. Hensle, E. A. Reiley, H. E. Fox, T. Haus

Research output: Contribution to journalArticle

Abstract

Continent urinary diversion has become a common form of bladder management for the female exstrophy patient in whom primary reconstruction has failed. Reported are the results of successful pregnancies in four young adult females, who had previously undergone a flap vaginoplasty as part of earlier management and more recently a continent right colonic urinary reservoir with a perineal stoma (Indiana pouch). Pregnancy in each of these patients was characterized by several urinary tract infections, cervical prolapse and mild to severe maternal hydronephrosis. All of the patients had some degree of difficulty with clean intermittent catheterization. One patient required an indwelling catheter with prolonged bed rest. Maternal hydronephrosis resolved after delivery in all instances. All four patients delivered their infants by way of cesarean section, either emergently for maternal or fetal distress or electively. Cervical prolapse did not resolve in three patients and will require surgical repair. After delivery, all patients returned to their previous pattern of clean intermittent catheterization without loss of continence. All the infants delivered were healthy with appropriate weights and high Apgar scores (more than 8). Orthotopic (perineal stoma) continent urinary diversion is not a contraindication to pregnancy. However, our experience mandates delivery by cesarean section with close monitoring for maternal or fetal distress during gestation.

Original languageEnglish (US)
Pages (from-to)405-409
Number of pages5
JournalSurgery Gynecology and Obstetrics
Volume177
Issue number4
StatePublished - 1993
Externally publishedYes

Fingerprint

Urinary Diversion
Pregnancy
Mothers
Intermittent Urethral Catheterization
Fetal Distress
Hydronephrosis
Prolapse
Cesarean Section
Continent Urinary Reservoirs
Bed Rest
Indwelling Catheters
Apgar Score
Urinary Tract Infections
Young Adult
Urinary Bladder
Weights and Measures

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Surgery

Cite this

Kennedy, W. A., Hensle, T. W., Reiley, E. A., Fox, H. E., & Haus, T. (1993). Pregnancy after orthotopic continent urinary diversion. Surgery Gynecology and Obstetrics, 177(4), 405-409.

Pregnancy after orthotopic continent urinary diversion. / Kennedy, W. A.; Hensle, T. W.; Reiley, E. A.; Fox, H. E.; Haus, T.

In: Surgery Gynecology and Obstetrics, Vol. 177, No. 4, 1993, p. 405-409.

Research output: Contribution to journalArticle

Kennedy, WA, Hensle, TW, Reiley, EA, Fox, HE & Haus, T 1993, 'Pregnancy after orthotopic continent urinary diversion', Surgery Gynecology and Obstetrics, vol. 177, no. 4, pp. 405-409.
Kennedy WA, Hensle TW, Reiley EA, Fox HE, Haus T. Pregnancy after orthotopic continent urinary diversion. Surgery Gynecology and Obstetrics. 1993;177(4):405-409.
Kennedy, W. A. ; Hensle, T. W. ; Reiley, E. A. ; Fox, H. E. ; Haus, T. / Pregnancy after orthotopic continent urinary diversion. In: Surgery Gynecology and Obstetrics. 1993 ; Vol. 177, No. 4. pp. 405-409.
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