Pregnancy after lower urinary tract reconstruction for XXXX .

@entity1 @entity154 @entity3570 @entity322 @entity1494 @entity306 @entity3025 @entity14422 @entity2885 @entity1011 @entity7890 @entity293 @entity10145
OBJECTIVE: To evaluate the effect of pregnancy on renal function, and the effect of congenital urinary tract abnormality and reconstruction on pregnancy and delivery. @entity1 AND METHODS: The case notes were reviewed of 20 @entity1 (median age 32.5 years) who had had 29 live babies. Data collected included @entity1 demographics, @entity154 , urological reconstructive procedure(s) and any subsequent urological complications. Pregnancy details, including urological and obstetric complications, presentation and mode of delivery, were obtained via a postal questionnaire from the relevant obstetrician. RESULTS: Seven @entity1 had exstrophy- @entity7890 , seven @entity3570 , two @entity10145 , and one each @entity306 , @entity7890 , @entity1494 with @entity3025 and @entity322 . They had had a mean (range) of 5.7 (1-12) urological reconstructive procedures each. @entity1 with exstrophy- @entity7890 had significantly more operations (mean 7.8) than those with @entity3570 (mean 4.14) or other diagnoses (mean 2.6) (P < 0.01). At the last follow-up 13 @entity1 had an enterocystoplasty, six a neobladder and one an ileal conduit. @entity14422 were @entity293 in 15, upper tract obstruction requiring nephrostomy and stent in three, Mitrofanoff difficulties in two and @entity2885 in one. There was no significant deterioration in glomerular filtration rate or serum @entity1011 after pregnancy. Only 10 of the births were normal or assisted vaginal deliveries. Seven @entity1 had emergency and 12 had elective Caesarean sections for obstetric indications, including four breech births in the seven @entity1 with vesical exstrophy. CONCLUSIONS: Pregnancy has no long-term effect on renal function and does not compromise reconstruction. Although there is a substantial complication rate and an increased need for Caesarean section, pregnancy in @entity1 with lower urinary tract reconstruction for congenital urological abnormalities is ultimately safe for both mother and baby. Interdisciplinary co-operation is desirable for a successful outcome.
