Successful pregnancy and delivery in a patient with a Mainz-II pouch urinary diversion: Case report and literature review

Abstract

This case report describes the successful management of a 16-year-old primigravida of Black African descent who had undergone Mainz-II ureterosigmoidostomy during infancy. Mainz-II ureterosigmoidostomy as a urinary diversion presents unique management challenges, particularly in pregnant patients. The patient presented to the antenatal clinic after a spontaneously achieved pregnancy; she had normal findings on obstetric and renal ultrasound scans throughout her pregnancy. At 38 weeks of gestation, an elective caesarean section was performed; the absence of the urinary bladder and the intact condition of the Mainz-II pouch were confirmed. A healthy biological male infant weighing 2.3 kg was delivered. Postoperatively, the patient experienced a mild superficial surgical site infection but otherwise had an uneventful recovery. This case underscores the importance of comprehensive prenatal care and meticulous surgical planning in managing pregnancies in patients with complex urinary diversions, and demonstrates that favorable maternal and neonatal outcomes can be achieved with appropriate medical oversight.