PREGNANCY AFTER MAINZ POUCH URINARY-DIVERSION

Purpose: We report on our experience with pregnancies and deliveries i n patients with a continent ileocecal reservoir with catheterizable st oma (Mainz pouch). Materials and Methods: Six women aged 18 to 33 year s (mean age 26.8 years) became pregnant after undergoing urinary diver sion. A continent ileocecal reservoir was made comprising 5 umbilical stomas and 1 stoma in the left lower abdominal quadrant. Underlying di seases were bladder exstrophy in 4, meningomyelocele in 1 and urogenit al sinus in another patient. Cesarean section was jointly performed by the obstetricians and urologists in all patients. Results: Seven preg nancies occurred in a total of 6 women. Three pregnancies were complet ely uneventful. Pregnancy complications were ureteral dilatation in 4 cases with pyelonephritis and premature labor in 1 case. A nipple prol apse in the patient with the stoma in the left lower abdominal quadran t was easily corrected during cesarean section. All patients underwent cesarean section without complications. Seven healthy children were b orn. Conclusions: In women with Mainz pouch urinary diversion there ap pears to be no contraindication to pregnancy, while other forms of con tinent diversion await further evaluation, Urologists and obstetrician s should be aware of the potential complications of this high risk pre gnancy and delivery, and their interdisciplinary cooperation is essent ial for successful outcome.