An observational study in Placenta Percreta, Bladder Injury and Sutures, sponsored by Necmettin Erbakan University. Completed at 1 site in Turkey. Open to female participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2024-02-20.
Sponsored by Necmettin Erbakan University · Observational
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.
147 studies on the registry are indexed under Placenta Accreta; 39 are open to participants now.
This study's enrollment of 81 is close to the median of 84 across 79 observational studies indexed under Placenta Accreta.
Browse Placenta Accreta studies →Necmettin Erbakan University is the lead sponsor of 198 studies on the registry; 48 are open to participants now.
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Pregnant women who underwent surgery for PAS and bladder invasion between January 2018 and January 2023 in a tertiary university hospital in Turkey.
Exclusion Criteria:
This group consisted of patients in whom we could not open the bladder and uterine cervix by dissection, so we had to open the bladder. In this group, the bladder dome was opened and a special suture was passed through the bladder to control bleeding. This procedure was performed to control bleeding.
Procedure: ACAR-Style Bladder Suture
For the patients in this group, the vascular structures between the bladder and cervix were coagulated one by one. The bladder was not opened during this procedure.
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.
Comparison of intraoperative bleeding and complication rates of the two groups
It was observed that the amount of intraoperative bleeding (volume aspirated cc blood), surgical time (minutes), blood transfusion rates (%), and hysterectomy rates(%).
Time frame: during operation time
Comparison of postoperative bleeding between two groups
It was observed that the amount of postoperative bleeding (hemoglobin(g/dL) change, need for blood transfusion Unite)
Time frame: postoperative three days,
Comparison of complication rate between two groups
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.
Time frame: six months postoperatively
Plan to share: Undecided
This study is completed, as verified in Feb 2024. You cannot join it, but the record below documents what was studied.
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Necmettin Erbakan University