ABSTRACT
AIMS: To assess the impact of sacral neuromodulation (SNM) on pregnancy and vice-versa, by identifying women who had received SNM for lower-urinary tract symptoms (LUTS) and had become pregnant. METHODS: A cross-sectional descriptive study was carried out based on responses to an on-line questionnaire sent to practitioners listed on the InterStim enCaptureTM National Registry. Questions were related to pre-pregnancy health and SNM efficacy, deactivation of the device, its impact on LUTS, childbirth, the infant, its reactivation and postpartum effectiveness. RESULTS: Twenty-seven pregnancies were recorded among 21 women. Six women had had a pregnancy prior to implantation, two of whom had had a c-section. A total of 18.5% of women had the device disabled prior to conception. The others had their device disabled during the first trimester and did not reactivate it before delivery. Complications were reported in 25.9% of pregnancies: six women had urinary infections, including three of the four treated for chronic retention of urine (CRU), and 1 woman had pain at the stimulation site. There were 24 live births (including one premature birth and four c-sections), one spontaneous miscarriage and two voluntary interruptions of pregnancy. No neonatal disorders have been reported. Effectiveness of sacral neuromodulation decreased in 20% in postpartum. CONCLUSIONS: In 27 pregnancies established during SNM for LUTS, 18.5% of patients deactivated their case before pregnancy and the others switched it off during the first trimester. Three-quarters of women with CRU had urinary infection. No adverse effects on fetuses were found. SNM effectiveness deteriorated in 20% cases after childbirth.
Subject(s)
Electric Stimulation Therapy/methods , Lower Urinary Tract Symptoms/therapy , Adult , Cross-Sectional Studies , Electrodes, Implanted , Female , Humans , Parturition , Pregnancy , Pregnancy Outcome , Retrospective Studies , Surveys and QuestionnairesABSTRACT
High-level competition sports can have a variety of negative effects on the female urogenital apparatus. Perineal trauma is rare and is usually associated with certain sports (impalement or hydrotubation during water-skiing, indurated perineal nodules in racing cyclists, and horse-riders' perineum). Effort incontinence is seen in all sports involving abrupt repeated increases in intra-abdominal pressure that may exceed perineal floor resistance. Sportswomen should be questioned about possible incontinence and be informed of preventive and therapeutic measures.
