Thesis (M.Sc.)-Cairo University, 2023.

Bibliography: pages 57-76.

Background: Caesarean hysterectomy is one of the identified risk factors
for bladder injuries at emergency delivery.
Objective: To assess the lower urinary tract dysfunction after 3 months of
caesarean hysterectomy in cases of placenta previa and placenta accreta
spectrum (PAS) by history and urodynamic studies.
Patients and Methods: 50 women who were admitted to department of
Gynecology and Obstetrics, Kasr Al-Ainy University Hospital, Cairo
University were included and divided into 2 groups:
Group (1) (CS-Hysterectomy group): 25 women who had caesarean
hysterectomy for placenta previa and PAS.
Group (2) (CS group): 25 women who had delivered by lower segment
caesarean section (LSCS).
Assessment was done after 3 months of delivery. All patients underwent
blood glucose test, urine analysis by midstream specimen, history taking
including detailed history for lower urinary tract symptoms and the
degree of bother results from each symptom, full general examination,
local gynecological examination, cough test for detection of stress
incontinence, and the urodynamic studies.
Results: In CS group, 2 (8.0%) women had stress urinary incontinence
(SUI) and 5 (20.0%) had urge urinary incontinence (UUI). While in CS-
Hysterectomy group, 7 (28.0%) women had SUI and 4 (16.0%) had UUI.
However, no significant difference was reported between both studied
groups regarding incidences of urological symptoms or severity of
urinary incontinence. No significant difference was reported between
both studied groups regarding maximum flow rate, flow time, time to


both studied groups regarding incidence of detrusor over-activity, results of
first sensation to void, second urge sensation, or maximum cystometric
capacity.
Conclusion: Caesarean hysterectomy for patients with placenta
previa and placenta accreta spectrum didn’t significantly increase the
lower urinary tract dysfunction 3 months postoperative when
compared with lower segment caesarean sectio

يعد إستئصال الرحم القيصري من أهم الإجراءات المتخذة لإنقاذ الحياة في حالات النزيف الرحمي بعد الولادة بسبب المشيمة المتقدمة والمشيمة الملتصقة في حال فشل العلاج التحفظي. تهدف هذه الدراسة الي تقييم الخلل الوظيفي السفلي للمسالك البولية بعد مرور ثلاثة اشهر من إستصال الرحم القيصري في حالات المشيمة المتقدمة والمشيمة الملتصقة عن طريق التاريخ المرضي ودراسة ديناميكية التبول. إشتملت الدراسة علي مجموعتين وهما مجموعه إستصال الرحم القيصري ومجموعة القيصرية السفليه وكل مجموعة منهما تضمنت 25 سيدة. وأستنتجنا من الدراسة أن إستئصال الرحم القيصري في حالات المشيمة المتقدمة والمشيمة الملتصقة لا يزيد بشكل كبير من الخلل الوظيفي السفلي للمسالك البوليه بعد 3 أشهر من الجراحة مقارنة بالعملية القيصرية السفلية.

Issues also as CD.

Text in English and abstract in Arabic & English.