Jurnal Urologi Universitas Airlangga
ISSN 23026480
Vol. 1 / No. 1 / Published : 2013-01
Order : 2, and page :2 - 2
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Original Article :
Placenta percreta with bladder invasion
Author :
- I Wayan Suarsana*1
- A.A. Gde Oka*2
- no data
- no data
Abstract :
objective: to present diagnosis and treatment of rare case, placenta percreta with bladder invasion case report: a 33-year-old lady, gravida 3 para 2 with 2 previous caesarean section was consulted to our department at 20 weeks gestation for gross hematuria since 10 days before. she also got lower abdominal pain without LUTS. there are no history of genitourinary track trauma, genitourinary and gastrointestinal malignancy and urolithiasis. she cwas diagnosed with auto immune hemilitic anemia (AIHA) warm type by the internist and has been treated with methyl prednisolon 125 mg twicw daily and packed red cell transfusion. she has got a vesicostomy at hospital that referred her to sanglah hospital. cystoscopy revealed a pathological tisue and blood vessel dilatation with active bleeding on the bladder dome. it also revealed a vesicocutan fistel. blood cloth evacuation, partial dome excision and cauterisation and vesicocutan fistel repair has been performed, followed by a caesaeran section and hysterectomy. the result of pathology anatomy study was placenta percreta with invasion to uterine serosa and bladder wall. 5 days after discharged from hospital, the patient came to urology clinic with urine catheter. there is no gross hematuria. the vesicocutan fistel has not been cured yet. discussion: placenta percreta with bladder invasion in this patient was diagnosed after cystoscopy and pathology anatomi study. USG was not performed because in this case we think that cystoscopy has an equal diagnostic value compared to USG. resection of bladder wall that invade by the placenta percreta can stop the gross hematuria caused by abnormal placenta implantation. cesarean section and hysterectomi was performed to this patient according to the AIHA and corticosteroid treatment that can disturb the optimal condition for the fetal growth. postoperative wound healing problem is the effect of corticosteroid treatment. conclusion: partial resection of the bladder wall is a true choice of surgical treatment for a placenta percreta with bladder invasion, but in the presence of auto immune hemolitic anemia as a comorbid disease, wound healing is a postoperative problem that need a special attention because of the corticosteroid treatment of AIHA.
Keyword :
placenta percreta, bladder invasion, no data, no data, no data,
References :
Edwin WHT,(2007) Lesson learn from 2 women with morbidly adherent placentas and a review of literature Singapore : Ann Acad Med
Abbas J,(2000) Placenta percreta with bladder invasion as a cause of life threathening hemorrhage no data : J Urol
Gielchinsky Y,(2002) Placenta accreta - summary of 10 years: a survey of 310 cases no data : Journal of placenta
Thakrar DJ,(2004) Antepartum diagnosis of placenta accreta no data : Indian Journal of radiology imaging
Stolpen,(2001) Antepartum evaluation of suspected placenta accreta: is there a role for MRI? no data : Magnetic Resonance Med
Archive Article
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Volume : 1 / No. : 1 / Pub. : 2013-01 |
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