Urological lesions in patients undergoing obstetric hysterectomy secondary due to abnormal placental insertion in a high specialty hospital.

Autor:	Jiménez-Vieyra CR; División de Ginecología. Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México., Gómez-Suaste A; Servicio de Urología Ginecológica. Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México., Hinojosa-Cruz JC; Dirección de Educación e Investigación en Salud. Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México., García-Bello JA; División de Investigación en Salud. Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 3 Dr. Víctor Manuel Espinosa de los Reyes Sánchez, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México.
Jazyk:	angličtina
Zdroj:	Cirugia y cirujanos [Cir Cir] 2020; Vol. 88 (4), pp. 473-480.
DOI:	10.24875/CIRU.20000117
Abstrakt:	Objective: To describe frequency and identify risk factors for urological lesions in patients undergoing obstetric hysterectomy secondary to abnormal placental insertion in a high specialty hospital. Material and Methods: Transversal, retrospective study of patients underwent hysterectomy due to abnormal placental insertion, from 2017 to 2019; age, obstetric antecedents, comorbidities, type of abnormal placental insertion type of hysterectomy, site of urinary lesion, anesthesia, surgery time and bleeding were studied. Analyses were made with ji square and Kruskal Wallis tests with SPSS V20.0 program considering significative p values p < 0.05. Results: Clinical records of 96 patients with age 32.6 ± 6.1 years were analyzed. Accretism was present in 38.5%, incretism in 19.8% and percretism in 18.8%. Total hysterectomy was accomplished in 78 (81.2%) cases. Urinary lesion was present in 27 (28.1%); vesical in 19 (19.8%), ureteral in 6 (6.5%) and both in 2 (2.0%). Urinary lesion was significantly more frequent in those patients with more pregnancies (median 4 [interquartile range (IQR): 3-4] vs. 3 [2-4]; p= 0.004), more caesarean sections (4 [3-4] vs. 2 [1-3]; p < 0.001), hemorrhage (3000 mL [2000-4800] vs. 2000 mL [1200-3000]; p = 0.001), and more surgery time (3.75 h [3.5-4.0] vs. 3.0 [2.0-3.5]; p < 0.001). Conclusions: Urinary lesions in patients undergoing obstetric hysterectomy secondary to abnormal placental insertion are more frequent with higher number of pregnancies, caesarean sections, hemorrhage and surgery time. (Copyright: © 2020 Permanyer.)
Databáze:	MEDLINE
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