Pregnancy after augmentation cystoplasty: A case report

Abstract

A 31-year-old woman with a history of spina bifida occulta became pregnant after ileocystoplasty for her neurogenic bladder. During the pregnancy she had frequent episodes of febrile urinary tract infections, and progressive hydronephrosis appeared in the second trimester. At 23 weeks gestation she was complicated by severe pyelonephritis requiring the intervention with the placement of double pigtail ureteral stent. However, long term efficacy of ureteral stent was questionable and this indwelling catheter caused bacteriuria which was not eradicated by intravenous antibiotics. Classical cesarean section was performed at 32 weeks of gestation due to the fear of fetal distress. Neobladder and mesenteric blood supply were adherent to the anterior surface of the uterus. Urinary tract infection is extremely common during pregnancy after enterocystoplasty. The most important point is prophylactic antibiotics throughout the pregnancy. At the time of cesarean section, a reconstructive urological surgeon should be part of the operative team and take great care to avoid injury to the blood supply of cystoplasty.