Urologic morbidity associated with placenta accreta spectrum surgeries: single-center experience with a multidisciplinary team

Erfani, Hadi; Salmanian, Bahram; Fox, Karin A.; Coburn, Michael; Meshinchiasl, Nazlisadat; Shamshirsaz, Amir A.; Kopkin, Rachel; Gogia, Soumya; Patel, Kunal; Jackson, Josef; Cadena, Max; Aalipour, Soroush; Sukumar, Shyamsunder; Espinoza, Jimmy; Clark, Steven L.; Belfort, Michael A.

doi:10.1016/j.ajog.2021.08.010

Cited by 22 publications

(27 citation statements)

References 14 publications

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“…Prior data suggest that patients with more severe histopathologic disease are more likely to benefit from prophylactic stent placement. 6 In contrast, our study found that the odds of urinary tract injury were essentially unchanged when controlling for disease severity, suggesting that patients with all degrees of disease severity benefit from prophylactic stents.…”

Section: Discussioncontrasting

confidence: 71%

“…A recent case–control study of 292 patients with and without urologic injury at the time of hysterectomy for placenta accreta spectrum found no protective association of prophylactic ureteral stents (which had been used in the majority of placenta accreta spectrum cases). 6 In contrast, a 2012 systematic literature review of 90 cases found a significant reduction in genitourinary injuries with ureteral stent placement compared with without ureteral stent placement (6% vs 33%, P =.01). 7…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Prophylactic Ureteral Stent Placement and Urinary Injury During Hysterectomy for Placenta Accreta Spectrum

Scaglione

Allshouse

Canfield

et al. 2022

Obstetrics &Amp; Gynecology

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To evaluate the association between prophylactic ureteral stent placement at the time of hysterectomy for placenta accreta spectrum and genitourinary injury. METHODS:We conducted a retrospective cohort study of patients with placenta accreta spectrum who underwent hysterectomy at two referral centers from 2001 to 2021. The exposure was prophylactic ureteral stent placement. The primary outcome, genitourinary injury, was a composite of bladder injury, ureteral injury, or vesicovaginal fistula. Secondary outcomes included components of the primary outcome. We evaluated differences between groups using x 2 and t test. To evaluate differences in the primary outcome, we reported odds ratios (ORs) and adjusted odds ratios (aORs) using multivariable logistic regression analyses to control for potential confounding variables. We used a Cochran-Armitage x 2 trend test to evaluate difference in stent use and injury over time.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 93%

Prophylactic Ureteral Stent Placement and Urinary Injury During Hysterectomy for Placenta Accreta Spectrum

Scaglione

Allshouse

Canfield

et al. 2022

Obstetrics &Amp; Gynecology

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“…This is a routine procedure at our hospital which purposed to avoid the ureteric injury. According to Erfani H et al, greater depth of invasion in PASD was associated with more frequent and severe adverse urologic events [39]. In our study, there was 1 case of an unexpected injury, accounting only for 1.5%.…”

Section: F O R P U B L I C a T I O Nsupporting

confidence: 47%

A novel approach in the management of placenta accreta spectrum disorders at Tu Du Hospital: a single-center surgical experience from Vietnam

Pham¹,

Vuong²,

Vuong³

et al. 2022

It Journ Gyn Obs

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Objective:The goal was to describe some primary outcomes including intraoperative and postoperative adverse events such as blood loss amount, blood transfusion amount, operative time, the length of hospital stay as well as unexpected complications of uterine conservative surgery. The secondary outcome was to determine the success rate in approaching the management of placenta accreta spectrum disorders (PASD). Materials and Methods:A retrospective observational study enrolled 65 patients from January 2017 to December 2018 at Tu Du Hospital, in Vietnam. The study included all the pregnant women underwent caesarean delivery due to PASD diagnosed preoperatively by ultrasound or upon laparotomy and gestational age was more than 28 weeks. Additionally, all patients were performed with uterine conservative surgery from January 2017 to December 2018.Results: Overall, the rate of successful preservation was 93.8%. Other main parameters evaluated as average operative blood loss was 987mL, mean blood transfusion was 831 ± 672 mL; mean operative time was 135 ± 31 minutes and average postoperative time was 5.79 days. Postoperative complications included six out of 65 cases due to intraoperative bleeding and postoperative infection, requiring peripartum hysterectomy in 4 patients. Conclusion:Uterine conservative surgery is related to less operative blood loss and blood transfusion amount. Thus, this method had a high success rate in preserving the uterus. Further studies might be necessary to evaluate the long-term effects of this method in PASD management.

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“…Leakage is a common complication of surgeries and injuries. , For example, post-operative bleeding is a leakage of blood and is of high risk in various surgical procedures . In the field of obstetrics and gynecology, catastrophic bleeding has become the main source of morbidity and mortality for women suffering from placenta accrete spectrum, and sometimes hysterectomy has to be performed to stop the bleeding. , After lung resections, the incidence of air leakage was reported to be around 50% not only causing suboptimal pain control, nausea, and vomiting but also resulting in a financial cost of approximately €39,000 per patient . Moreover, cerebrospinal fluid leakage and gastric fluid leakage also lead to pain and death .…”

Section: Introductionmentioning

confidence: 99%

Cohesion Design-Led Tough Sealants with Controllably Dissolvable Properties

Duan

Zhu

et al. 2022

ACS Appl. Mater. Interfaces

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Leakage is a common complication of surgeries and injuries, causing pain and increasing the economic burden on patients. Although there are commercially available sealants for leakage prevention, few of them are entirely satisfactory due to disease transmission, high cost, and poor biocompatibility. In addition, none of them can be controllably removed for further healthcare. In this paper, by using cohesion design, a sealant based on amino-modified gelatin (AG) and bi-polyethylene glycol N-hydroxysuccinimide active ester (Bi-PEG-SS) was fabricated. To increase the bursting pressure, the cohesion strength was enhanced by increasing the cross-linking density of the sealant. To endow the sealant with controllably dissolvable properties, the smart succinic ester units were introduced into the cohesion network. Both the in vitro and in vivo experiments showed that this sealant processed high bursting pressure with efficient hemorrhage control. Moreover, no side effects were observed after 7 days of in vivo sealing, including little inflammation and fibrogenesis. These results, together with the easy availability of the raw materials, revealed that this sealant might be a promising alternative for leakage sealing.

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Urologic morbidity associated with placenta accreta spectrum surgeries: single-center experience with a multidisciplinary team

Cited by 22 publications

References 14 publications

Prophylactic Ureteral Stent Placement and Urinary Injury During Hysterectomy for Placenta Accreta Spectrum

Prophylactic Ureteral Stent Placement and Urinary Injury During Hysterectomy for Placenta Accreta Spectrum

A novel approach in the management of placenta accreta spectrum disorders at Tu Du Hospital: a single-center surgical experience from Vietnam

Cohesion Design-Led Tough Sealants with Controllably Dissolvable Properties

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