For a study, researchers sought to assess the relationship between genitourinary damage and preventative ureteral stent implantation after a hysterectomy for placenta accreta spectrum.
Patients with placenta accreta spectrum who had hysterectomy at two referral sites between 2001 and 2021 were the subject of a retrospective cohort analysis. Prophylactic ureteral stent implantation was the exposure. Genitourinary damage, which was the main result, included bladder injury, ureteral injury, and vesicovaginal fistula. The primary outcome components were included in secondary outcomes. Using a χ2 & t test, they assessed group differences. They used multivariable logistic regression analyses to account for possible confounding factors and presented odds ratios (ORs) & adjusted odds ratios (aORs) to assess differences in the primary outcome. To assess how differences in stent usage and injury over time differed, they employed a Cochran-Armitage χ2 trend test.
There were 236 patients involved in all. The use of preventative ureteral stents was employed in 156 operations (66%) Overall, the stent group experienced genitourinary damage less frequently than the no-stent group (28% vs. 51%, OR 0.37, 95% CI 0.21-0.65). After adjusting for the urgency of delivery, three or more prior cesarean births, and the presence of a gynecologic oncologist, this connection was maintained (aOR 0.27, 95% CI 0.14-0.52). Unintentional bladder damage and ureteral injury were less common in the stent group compared to the no stent group (13% vs. 25%, P=.018) and (2% vs. 9%, P=.019), respectively.
Placement of a preventative ureteral stent was linked to a lower incidence of genitourinary damage following a hysterectomy for placenta accreta spectrum.
