Aftermath of a Midurethral Sling Placed in the First Trimester: A Case Report.

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.

Female pelvic medicine & reconstructive surgery. 2019 Sep 05 [Epub ahead of print]

Breffini Anglim, Colleen D McDermott

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.

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