Pregnancy After Transvaginal Sling for Stress Urinary Incontinence

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.