Obstetrical management following incontinence surgery

OBJECTIVE: To analyze in a retrospective fashion our experiences with obstetrical management following previous incontinence surgery. METHODS: Between 1990 and 1997 4 women presented to our institution in the third trimester of pregnancy with a history of colposuspension performed 3 months to 4 years before onset of pregnancy for second degree stress incontinence. Three of 4 patients experienced recurrent incontinence during the third trimester. RESULTS: A cesarean section was performed before the onset of labor in all 4 patients. Postpartal pelvic floor exercises were prescribed and a follow-up ensued after 6 and 11 months in the form of a questionnaire. While incontinence persisted in 2 patients for 6 months, all 4 patients demonstrated complete continence after one year. CONCLUSIONS: We consider an elective cesarean section to be the optimal mode of delivery in women with a history of incontinence surgery.