Pregnancy Following Clam Cystoplasty and Mitrofanoff Procedure in a Patient With Fowler's Syndrome and Detrusor Overactivity

福勒氏综合征和逼尿肌过度活动症患者行膀胱成形术和米特罗凡诺夫手术后妊娠

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Abstract

Fowler's syndrome causes urinary retention due to failure of the urethral sphincter to relax. Management aims for complete bladder emptying, typically via intermittent self-catheterization. If conservative treatment fails, detrusor overactivity with Fowler's syndrome may be managed surgically using clam cystoplasty and the Mitrofanoff procedure to increase bladder capacity and reduce pressure. We report a rare case of pregnancy in a woman with Fowler's syndrome and detrusor overactivity, who previously underwent clam cystoplasty and Mitrofanoff procedure. She had a continent, functional abdominal stoma for clean intermittent catheterization. Her pregnancy was complicated by recurrent urinary tract infections and bladder spasms requiring antibiotics. A planned cesarean section was performed at 35 weeks following steroid administration and discussion with the multidisciplinary team, resulting in the delivery of a live baby. This case illustrates pregnancy management complexities in these women, focusing on the need for individualized, multidisciplinary care.

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