Pauline Roulette1, Evelyne Castel-Lacanal2, Sylvain Sanson3, Romain Caremel4, Véronique Phé5, Stéphane Bart6, Franck Duchêne7, Marianne De Sèze8, Alexia Even9, Andréa Manunta10, Maria C Scheiber-Nogueira11, Pascal Mouracade12, Catherine-Marie Loche13, Emmanuel Chartier-Kastler5, Alain Ruffion14, Gilles Karsenty15, Xavier Gamé1. 1. Department of Urology, Andrology and Transplantation, CHU Rangueil, Toulouse, France. 2. Department of Physical Medicine and Rehabilitation, CHU Rangueil, Toulouse, France. 3. Department of Urology, Clinique du Pont de Chaume, Montauban, France. 4. Clinique du Cèdre, Cèdre's Urology Center, Bois Guillaume, France. 5. Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Pitié-Salpêtrière Academic Hospital, Paris, France. 6. Department of Urology, CH René-Dubos, Pontoise, France. 7. Clinique de l'Alliance, Department of Urology, Saint Cyr sur Loire, France. 8. Clinique Saint Augustin, Neuro-Urology, Pelviperineology and Urodynamic Clinical Center, Bordeaux, France. 9. Department of Physical Medicine and Rehabilitation, Hôpital Raymond-Poincaré AP-HP, Garches, France. 10. Department of Urology, University Hospital of Rennes, Rennes, France. 11. Department of Neurology, Hospices Civils, Lyon, France. 12. Department of Urology, Strasbourg University Hospital, Strasbourg, France. 13. Department of Physical Medicine and Rehabilitation, Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital, Créteil, France. 14. Department of Urology, Centre hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite Cedex, France. 15. Department of Urology and Kidney Transplantation, Assistance Publique Hôpitaux de Marseille, Marseille, France.
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.
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.