Uterovesical fistulas are a rare cause of urinary incontinence. They are most frequently caused by repeated Caesarean sections and generally have to be closed by a transperitoneal approach in an interdisciplinary setting not only to regain continence but also to prevent infertility.
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Up-front dissection of the uterovesical space or "bladder-first approach" reduces hemorrhage and bladder injury during hysterectomy for placenta accreta spectrum: reconfirmed in 78 more cases in a prospective single-center study.
AJOG Glob Rep
February 2025
Urology (Mavuduru), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Background: Cesarean hysterectomy for placenta accreta spectrum disorder may be associated with severe hemorrhage because of placental invasion of the myometrium and the uterovesical space or parametrium. It leads to serious complications, such as massive hemorrhage requiring massive transfusion, coagulopathy, bladder and ureteric injuries, need for intensive care unit admission and prolonged hospital stay. To reduce the complications of cesarean hysterectomy for placenta accreta spectrum disorder, ongoing efforts are being made to develop different surgical approaches.
View Article and Find Full Text PDFDevelopment and validation of a model to preoperatively predict the risk of placenta accreta spectrum in women with placenta previa.
Adv Clin Exp Med
December 2024
Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
Article Synopsis
- * Researchers analyzed data from 437 patients to identify risk factors for PAS using logistic regression, creating a predictive model validated by additional patient data, showing an AUC of 0.821.
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An Unusual Case of Pelvic Congestion Syndrome: A Case Report.
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View Article and Find Full Text PDFPrenatal identification of invasive placentation using ultrasound in women with placenta previa and prior cesarean delivery.
Eur J Obstet Gynecol Reprod Biol
November 2024
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
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Medicina (Kaunas)
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Department of Obstetrics and Gynecology, Medical Center, University Hospital Freiburg, 79106 Freiburg, Germany.
Placenta accreta spectrum (PAS) refers to the abnormal adhesion of the placenta to the myometrium, with varying degrees of severity. Placenta accreta involves adhesion to the myometrium, placenta increta invades the myometrium, and placenta percreta extends through the serosa to adjacent organs. The condition is linked to deficient decidualization in scarred uterine tissue, and the risk increases when placenta previa is present and with each prior cesarean delivery.
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