Sacral neuromodulation and pregnancy: Results of a national survey carried out for the neuro‐urology committee of the French Association of Urology (AFU)

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.