Placenta percreta with bladder invasion: The armamentarium available in its management

Placenta percreta is a rare life-threatening condition associated with high morbidity and mortality due to severe obstetric hemorrhage. It can be associated with bladder invasion which leads to hematuria. Treatment is decided on a case-to-case basis, and there have been no guidelines proposed so far...

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Main Authors: Neeraja Tillu, Abhishek Savalia, Sujata Patwardhan, Bhushan Patil
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Urology Annals
Subjects:
Online Access:http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=3;spage=324;epage=327;aulast=Tillu
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author Neeraja Tillu
Abhishek Savalia
Sujata Patwardhan
Bhushan Patil
author_facet Neeraja Tillu
Abhishek Savalia
Sujata Patwardhan
Bhushan Patil
author_sort Neeraja Tillu
collection DOAJ
description Placenta percreta is a rare life-threatening condition associated with high morbidity and mortality due to severe obstetric hemorrhage. It can be associated with bladder invasion which leads to hematuria. Treatment is decided on a case-to-case basis, and there have been no guidelines proposed so far. Strategies include obstetric hysterectomy, leaving the placenta in situ with postoperative methotrexate therapy and removal of the placenta with bladder reconstruction in a single stage. An unusual case of a patient with placenta percreta and bladder invasion who presented with delayed hematuria after the placenta was left in situ has been reported. The patient was managed conservatively for 10 days postdelivery after which a decision to do an obstetric hysterectomy with focal cystectomy was taken in view of persistent hematuria. An algorithm for managing cases of placenta percreta with bladder invasion has been proposed to manage these difficult situations.
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spelling doaj.art-4fb643c866a74dc78967bdabad5031862022-12-21T17:48:10ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342019-01-0111332432710.4103/UA.UA_84_18Placenta percreta with bladder invasion: The armamentarium available in its managementNeeraja TilluAbhishek SavaliaSujata PatwardhanBhushan PatilPlacenta percreta is a rare life-threatening condition associated with high morbidity and mortality due to severe obstetric hemorrhage. It can be associated with bladder invasion which leads to hematuria. Treatment is decided on a case-to-case basis, and there have been no guidelines proposed so far. Strategies include obstetric hysterectomy, leaving the placenta in situ with postoperative methotrexate therapy and removal of the placenta with bladder reconstruction in a single stage. An unusual case of a patient with placenta percreta and bladder invasion who presented with delayed hematuria after the placenta was left in situ has been reported. The patient was managed conservatively for 10 days postdelivery after which a decision to do an obstetric hysterectomy with focal cystectomy was taken in view of persistent hematuria. An algorithm for managing cases of placenta percreta with bladder invasion has been proposed to manage these difficult situations.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=3;spage=324;epage=327;aulast=TilluBladder invasionhematuriaplacenta percreta
spellingShingle Neeraja Tillu
Abhishek Savalia
Sujata Patwardhan
Bhushan Patil
Placenta percreta with bladder invasion: The armamentarium available in its management
Urology Annals
Bladder invasion
hematuria
placenta percreta
title Placenta percreta with bladder invasion: The armamentarium available in its management
title_full Placenta percreta with bladder invasion: The armamentarium available in its management
title_fullStr Placenta percreta with bladder invasion: The armamentarium available in its management
title_full_unstemmed Placenta percreta with bladder invasion: The armamentarium available in its management
title_short Placenta percreta with bladder invasion: The armamentarium available in its management
title_sort placenta percreta with bladder invasion the armamentarium available in its management
topic Bladder invasion
hematuria
placenta percreta
url http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=3;spage=324;epage=327;aulast=Tillu
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