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Pregnancy After Transvaginal Sling for Stress Urinary Incontinence: A Case Series

Adams-Piper, Emily MD*; Darbinian, Jeanne MPH; Postlethwaite, Debbie RNP, MPH; Castillo, Peter A. MD*

Female Pelvic Medicine & Reconstructive Surgery: July/August 2014 - Volume 20 - Issue 4 - p 212–215
doi: 10.1097/SPV.0000000000000096
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Objectives The aim of this study is to assess the incidence, medical course, and outcomes of women who carried a pregnancy to delivery after the placement of a transvaginal mesh sling for treatment of stress urinary incontinence (SUI) in a closed health care system.

Methods We conducted a retrospective case series of 15 women identified within the Kaiser Permanente Northern California region based on coding for placement of a sling for SUI. Records were cross-matched against the records of live births. The electronic medical records of subjects were extensively reviewed.

Results Fifteen patients were identified and included in the analysis. Twelve patients had retropubic midurethral slings, 2 patients had transobturator slings, and one had a single-incision sling procedure. Ten of 15 were delivered via cesarean delivery. Five of the 15 patients had concomitant prolapse surgery at the time of sling placement; all of these patients had cesarean deliveries. There were no reports of voiding dysfunction or sling-related complications during pregnancy. Eleven of 15 patients were dry after the sling procedure, and 9 of the 15 were dry after delivery. No patients have had additional procedures or interventions for SUI after pregnancy.

Conclusions Our case series may suggest that vaginal delivery is not contraindicated and sling-related complications during pregnancy are not prevalent.

We present the second largest case series to date of women who become pregnant and deliver following the placement of a transvaginal mesh sling for treatment of stress urinary incontinence.

From the *Department of Obstetrics and Gynecology, Kaiser Permanente, Santa Clara; and †Division of Research, Kaiser Permanente, Oakland, CA.

Reprints: Emily Adams-Piper, MD, Department of Obstetrics and Gynecology, Kaiser Permanente, Santa Clara Homestead Med Center, 710 Lawrence Expressway, Dept 390, Santa Clara, CA 95051. E-mail:

The authors have declared they have no conflicts of interest.

D. Postlethwaite: Research funding support for an unrelated study, Bayer HealthCare Pharmaeutical Inc.

This study has been accepted for oral presentation at the 2013 American Urogynecologic Society Annual Scientific Meeting. It is being submitted for fast-track review.

© 2014 by Lippincott Williams & Wilkins