Bladder injury during cesarean section : a case control study for 10 years

Abstract EN

Objective : To determine the incidence, risk factors and management of bladder injury during Caesarean section.

Design : Retrospective study.

Setting : Abha Maternity Hospital, Asir, Saudi Arabia.

Method : The medical records of all the patients who had bladder injury during Cesarean section in 10 years period (2000-2010) were reviewed.

Two cases were chosen for every case of bladder injury as control.

Personal characteristic, obstetric, surgical details, mechanism of injury, anatomic location, diagnosis, management and outcome were assessed for both (case and control) groups.

Result : Twenty-four cases of bladder injury were indentified among 10,765 Cesarean sections done during the study period, an incidence of 0.22 %.

Bladder injury occurred frequently with prior surgery including Cesarean section (62.5 % versus 43.7 %, p = 0.022), presence of adhesions (95.8 % versus 45.8 %, p < 0.0001), emergency Cesarean (87.5 % versus 37.5 %, p < 0.0001) and placenta previa and or accreta (41.6 % versus 2.1 %, p < 0.0001).

Conclusion : A prior Cesarean section, presence of abdominal and or bladder adhesions, emergency Cesarean and placenta previa and or accreta, all are significant risk factors for bladder injury during Cesarean section.

Bladder injury should be a part of discussion with the patients requesting Cesarean section.