{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:02:48Z","timestamp":1789984968861,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>This study assessed the prevalence, patterns, and risk factors of urologic injuries in patients with placenta accreta spectrum (PAS) undergoing cesarean hysterectomy, aiming to help clinicians identify high\u2010risk cases and optimize surgical planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study with a 6\u2010month postoperative follow\u2010up, patients with a diagnosis of PAS referred to Namazi Hospital for treatment between January 2015 and December 2024. These patients were monitored for 6 months after their cesarean section for long\u2010term urologic complications, and their demographic information, obstetric history, hospitalization course, and operation detail were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 115 patients (23.09%) had urologic injuries during cesarean section hysterectomy. Severe intraoperative blood loss (\u2265\u20093000\u2009mL), as a marker of surgical complexity, was strongly associated with urologic injury (adjusted OR 7.10, 95% CI 3.73\u201313.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Regarding pathology, placenta accreta was associated with a significantly lower risk of urologic injury compared with placenta percreta (adjusted OR 0.52, 95% CI 0.29\u20130.93;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), whereas placenta increta was not significantly associated (adjusted OR 0.90, 95% CI 0.50\u20131.60;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.71).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately one\u2010fifth of pregnant women with PAS undergoing cesarean hysterectomy develop urologic injuries. This emphasizes on having a multidisciplinary team of surgeons with adequate experience in the field of abnormal placental tissue involvement. Besides, efforts should be taken preoperatively with the use of sufficient diagnostic means to optimize the surgical planning and management to reduce the amount of blood loss and prevent surgical morbidities such as urologic damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72654","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:15:36Z","timestamp":1781154936000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Factors Associated With Urologic Injury in Patients With Placenta Accreta Spectrum Undergoing Cesarean Hysterectomy Over a 10\u2010Year Retrospective Cohort at a Tertiary Referral Center in Shiraz, Iran"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4064-4906","authenticated-orcid":false,"given":"Shaghayegh","family":"Moradi Alamdarloo","sequence":"first","affiliation":[{"name":"Maternal\u2010fetal medicine Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4134-9869","authenticated-orcid":false,"given":"Zahra","family":"Ovaisi","sequence":"additional","affiliation":[{"name":"Maternal\u2010fetal medicine Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1114-5937","authenticated-orcid":false,"given":"Hamide","family":"Barzegar","sequence":"additional","affiliation":[{"name":"Neonatal Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8154-877X","authenticated-orcid":false,"given":"Soroush","family":"Sadr","sequence":"additional","affiliation":[{"name":"Department of Urology, Faghihi Hospital Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7777-5934","authenticated-orcid":false,"given":"Alireza","family":"Dehghanmanshadi","sequence":"additional","affiliation":[{"name":"Department of Urology, Faghihi Hospital Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9101-0321","authenticated-orcid":false,"given":"Erfan","family":"Taherifard","sequence":"additional","affiliation":[{"name":"Shiraz School for Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aazam","family":"Faraji","sequence":"additional","affiliation":[{"name":"Maternal\u2010fetal medicine Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6345-1277","authenticated-orcid":false,"given":"Khadije","family":"Bazrafshan","sequence":"additional","affiliation":[{"name":"Maternal\u2010fetal medicine Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6398-1905","authenticated-orcid":false,"given":"Mohammad Reza","family":"Ensafdaran","sequence":"additional","affiliation":[{"name":"Department of Urology Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2711-8825","authenticated-orcid":false,"given":"Atefe","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Maternal\u2010fetal medicine Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.04.049"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70463-0"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2021.02.001"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.074"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.04.233"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.01.233"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1709324"},{"key":"e_1_2_17_9_1","doi-asserted-by":"crossref","unstructured":"R. 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