Spontaneous Pregnancy after Cystectomy and Urinary Diversion by Indiana Pouch Method for Congenital Bladder Exstrophy: A Case Report
Ali Irfan Güzel
Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey.
Aytekin Tokmak *
Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey.
Aydan Sezer Kara
Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey.
Ahmet Yalinkaya
Department of Obstetrics and Gynecology, Dicle University, Diyarbakır, Turkey.
*Author to whom correspondence should be addressed.
Abstract
Aims: To share our experience in the management of a patient of congenital bladder exstrophy, who conceived spontaneously following Indiana pouch surgery for urinary diversion.
Presentation of Case: 21 year old primigravida, who had undergone urinary diversion surgery for congenital bladder exstrophy, reported for antenatal care. In the first year of her life, an ineffective operation was performed for closure of her abdominal wall defect. At 10 years of age she underwent cystectomy, trygonocuteneostomy, diastasis of pubic bones were fixed and urinary diversion operation was performed by Indiana pouch method. She was followed up at the antenatal clinic of Dicle University until 38th week of pregnancy. Thereafter, an elective caesarean section was performed and a live healthy female baby was delivered.
Discussion and Conclusion: Bladder exstrophy is an extremely rare congenital abnormality. Woman with bladder exstrophy and lower urinary tract reconstruction surgery may conceive spontaneously. However they have a high risk pregnancy and an elective caesarian section is advocated for delivery. Review of literature and our experience is presented.
Keywords: Bladder exstrophy, Indiana pouch, spontaneous pregnancy, caesarean section.