“Filling the bladder” at Cesarean Hysterectomy for Placenta Percreta

Dear Editor,

Cesarean hysterectomy for placenta percreta is challenging. I commend Özcan et al. for describing “filling the bladder” for this surgery: this led to a shorter operative time/hospital stay, although it did not decrease the incidence of bladder injuries [1]. I wish to share my opinion with readers: the first merit of “filling the bladder” is reducing bleeding, making this surgery easier, and the possibility of avoiding bladder injury may be the second merit.

• References

• 1 Özcan HÇ, Balat Ö, Uğur MG. et al. Use of Bladder Filling to Prevent Urinary System Complications in the Management of Placenta Percreta: a Randomized Prospective Study. Geburtsh Frauenheilk 2018; 78: 173-178
• 2 Shellhaas CS, Gilbert S, Landon MB. et al. The frequency and complication rates of hysterectomy accompanying cesarean delivery. Obstet Gynecol 2009; 114: 224-229
• 3 Matsubara S, Kuwata T, Usui R. et al. Important surgical measures and techniques at cesarean hysterectomy for placenta previa accreta. Acta Obstet Gynecol Scand 2013; 92: 372-377
• 4 Matsubara S, Takahashi H, Baba Y. Handling aberrant vessels located in the posterior bladder wall in surgery for abnormally invasive placenta: a non/less-touch technique. Arch Gynecol Obstet 2017; 296: 851-853
• 5 Matsubara S. Caesarean hysterectomy for placenta praevia accreta: filling the bladder technique to identify an appropriate bladder separation site. J Obstet Gynaecol 2013; 33: 163-164
• 6 Matsubara S, Ohkuchi A, Yashi M. et al. Opening the bladder for cesarean hysterectomy for placenta previa percreta with bladder invasion. J Obstet Gynaecol Res 2009; 35: 359-363
• 7 Matsubara S. Bladder-opening technique for hysterectomy for placenta previa percreta. Arch Gynecol Obstet 2011; 283: 1427-1428