Handling aberrant vessels located in the posterior bladder wall in surgery for abnormally invasive placenta: a non/less-touch technique.

BACKGROUND: At cesarean hysterectomy for abnormally invasive placenta, rupture of aberrant vessels around the uterus causes massive bleeding.

PURPOSE: This study aimed at describing a technique to reduce bleeding from aberrant vessels at the posterior bladder wall in this surgery.

METHODS: The bladder is filled with 200-300 mL of water during handling the posterior bladder wall.

RESULTS: This technique facilitates understanding that some aberrant vessels do not have communications with the cervix-uterus. Some aberrant vessels have communication with the cervix-uterus and this technique makes cutting and ligation of these vessels easy.

CONCLUSIONS: Filling the bladder may reduce bleeding from the posterior bladder wall at cesarean hysterectomy for abnormally invasive placenta.