Caesarean hysterectomy (CH) is a standard treatment for placenta accreta spectrum (PAS) but it sometimes causes bladder/ureter injury. We attempted to test whether ureter dissection reduces the incidence of bladder/ureter injury at CH for PAS.
Methods: Patients with CH for PAS (n=140) was divided into two groups: ureter dissection (+) vs. (-). We compared the perinatal and surgical outcomes between the two groups.
Results: Two groups showed the same background characters: parity, frequency of previous miscarriages, or indication for hysterectomies. No significant differences in outcomes were observed between the two groups: operative time, perioperative blood loss, drop of hemoglobin, number of transfused RBC/plasma, or hospital-stay length. The following morbidities did not differ between the two groups: bladder/ureter/bowel injury, wound complications, ICU admission, and maternal mortality.
Conclusion: Ureteric dissection did not reduce bladder/ureter injury in CH for PAS.