Management of injuries to the urinary and gastrointestinal tract during cesarean section

Proper management of surgical injuries occurring during cesarean section is important to minimize patient morbidity. Damage to the bladder is usually easy to identify and repair. The defect is closed with two or three layers of absorbable suture, and an indwelling catheter is left in place for 1 week. The management of ureteral injuries depends on their nature, extent, location, and time of discovery; consultation with a urologist is advisable. Small, well-perfused injuries to both the small and large bowel can be repaired primarily. More extensive bowel damage may require resection. Colostomy is no longer mandatory for patients with injuries to unprepared large bowel.