Bladder Injury, Placenta Percreta, Sutures
Conditions
Keywords
Placenta Percreta, Bladder Invasion, Sutures
Brief summary
This study aimed to evaluate the short-term and long-term complications of placenta percreta with bladder invasion. This evaluation focuses on cases where bladder dissection and ACAR-style bladder sutures were applied in cases of placenta percreta with bladder invasion that underwent uterine-sparing surgery or hysterectomy.
Interventions
PROCEDUREACAR-Style Bladder Suture
In cases where dissection is not possible, the upper border of the bladder is opened transversely with a cutter, and the ureteral catheters and trigone inside the bladder are observed. The bladder invasion border is re-evaluated intravesically. The uterine arteries are held bilaterally with a sensitive clamp that does not crush the uterine arteries. Then, the uterus is incised from the upper border of the bladder without damaging the bladder and the predetermined myometrial invasion area is resected. After the placenta is removed, the cervical canal is found and marked with a number one vicryl suture. In these patients, the placental material is removed in pieces in the cervix area where the bladder is invaded. After the removal of the placenta, the cervix in the lower segment of the uterus is orientated and sutured together with the bladder, and this area is closed.
Sponsors
Necmettin Erbakan University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Pregnant women * Clinical diagnosis of PAS * PAS with bladder invasion
Exclusion criteria
* Cases with incomplete or inadequate medical records * Cases with other types of placental invasion (e.g., placenta accreta, placenta increta), * Cases with missing key data points.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of intraoperative bleeding and complication rates of the two groups | during operation time | It was observed that the amount of intraoperative bleeding (volume aspirated cc blood), surgical time (minutes), blood transfusion rates (%), and hysterectomy rates(%). |
| Comparison of postoperative bleeding between two groups | postoperative three days, | It was observed that the amount of postoperative bleeding (hemoglobin(g/dL) change, need for blood transfusion Unite) |
| Comparison of complication rate between two groups | six months postoperatively | It was described as long-term bladder dysfunction(Nocturia, Urgency, Stress urinary incontinance, fistula rate (%)) Nocturia: Waking up more than once during the night. Urgency: Sudden, intense urge to urinate followed by an involuntary loss of urine. Stress urinary incontinance: Happens when physical movement or activity - such as coughing, laughing, sneezing, running or heavy lifting - puts pressure (stress) on your bladder, causing you to leak urine. |
Countries
Turkey (Türkiye)
Outcome results
None listed