Early vs Late Bladder Dissection During CS Hysterectomy in Patients With PAS With Bladder Invasion

Early vs Late Bladder Dissection During Cesarean Hysterectomy in Patients With Placenta Accreta Spectrum With Bladder Invasion

Status

UNKNOWN

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT05752513

Enrollment

Registered

2023-03-02

Start date

2023-02-23

Completion date

2023-05-01

Last updated

2023-03-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cesarean Hysterectomy, Placenta Accreta Spectrum

Brief summary

Thirty-six singleton pregnant women with PAS and bladder invasion; total anterior or anterolateral invasion, who were scheduled for cesarean hysterectomy were randomly assigned into two equal groups * Group 1: included 18 pregnant women scheduled for classical cesarean hysterectomy for placenta accreta with or without ligation of anterior division of internal iliac artery before cesarean section. * Group 2: included 18 pregnant women scheduled for bladder last cesarean hysterectomy with or without ligation of anterior division of internal iliac artery.

Interventions

PROCEDURELate bladder dissection

The bladder dissection is reserved as the last step of the cesarean hysterectomy with excellent dissection of the ureteric course till the ureteric tunnel to reduce the incidence of inadvertent ureteric clamping during uterine vessel ligating and transection

PROCEDUREearly bladder dissection

The bladder dissection is early as in classic cesarean hysterectomy

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

DOUBLE (Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

FEMALE

Age

18 Years to 45 Years

Healthy volunteers

Yes

Inclusion criteria

1. Age: reproductive age. 2. Pregnant with singleton living fetus. 3. Previous one or more cesarean sections. 4. Gestational age: \> 34 weeks. 5. Elective or non-emergency cesarean sections. 6. Preoperative hemoglobin more than 9.5 gm/dl.

Exclusion criteria

Women with history of any medical disorder with pregnancy eg. gestational diabetes, hypertension, or anemia.

Design outcomes

Primary

Measure	Time frame
Amount of blood loss	during cesarean hysterectomy

Secondary

Measure	Time frame
Operative time	during cesarean hysterectomy
bladder injury	during cesarean hysterectomy
ureteric injury	during cesarean hysterectomy
Need for massive blood transfusion	during cesarean hysterectomy

Countries

Egypt

Contacts

Primary ContactAbdalla Mousa, Lecturer

Dr_abdallamousa@hotmail.com01277664430

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026