Pregnancy and delivery after vesico ileocystoplasty--a case report

Abstract

Neobladder is continent urinary reservoir made from a detubularized segment of bowel, with implantation of ureters and urethra. The most common indication for this operation is bladder replacement after cystectomy following bladder cancer in elderly or cervical cancer Stage IV patients. Nowadays indications are expanded to many benign diseases (interstitial cystitis (IC), neurogenic bladder, chronic pelvic pain) in reproductive age. Pregnancy in women with neobladder is a rare condition, hence published experience is limited. Most of the published cases were delivered by cesarean, due to the concern for possible complications. The authors report a case of a 36-year-old woman who underwent a vesico ileocystoplasty for IC, became pregnant six years after the operation, and delivered a healthy baby vaginally. Her obstetric and urologic outcomes were assessed, during, and after pregnancy. Careful antenatal monitoring by both an obstetrician and a urologist, awareness of potential complications, and their prompt treatment, can result in a successful pregnancy and vaginal delivery where neither fetus or mother nor neobladder are endangered.