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Bladder Injury During Cesarean Delivery.

Christopher M Tarney1

  • 1Womack Army Medical Center, Department of Obstetrics and Gynecology, 2817 Reilly Road, Fort Bragg, NC 28307, USA.

Current Women'S Health Reviews
|May 31, 2014
PubMed
Summary
This summary is machine-generated.

Cesarean sections, the most common surgery in the US, carry risks of bladder injury. Evidence supports some techniques like double-layer closure to reduce this risk, while others lack support.

Keywords:
Adhesionsbladder injurycesarean sectioncystotomyrepeat cesarean deliveryrisk factorurologic injury.

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Safety
  • Urology

Background:

  • Cesarean section is the most common surgery in the US, with over 30% of deliveries.
  • Urologic injury, particularly bladder damage, is the most frequent complication during obstetric and gynecologic surgery.
  • Risk factors for bladder injury during cesarean delivery include prior cesarean sections, adhesions, and emergent procedures.

Purpose of the Study:

  • To review current evidence on techniques used during cesarean sections that may impact the risk of bladder injury.
  • To identify practices supported by data and those lacking evidence.

Main Methods:

  • Literature review of studies investigating cesarean section techniques and their association with bladder injury.
  • Analysis of evidence supporting or refuting specific surgical practices.

Main Results:

  • Evidence supports double-layer hysterotomy closure, routine use of adhesive barriers, and Pfannenstiel skin incisions to decrease bladder injury risk.
  • No evidence supports the routine creation of a bladder flap to reduce injury risk.
  • Further research is needed on indwelling catheterization, uterine exteriorization, and hysterotomy extension methods.

Conclusions:

  • Certain techniques, such as double-layer closure and adhesive barriers, are evidence-based for reducing bladder injury during cesarean delivery.
  • Practices like the bladder flap are performed without supporting evidence.
  • More research is required to fully understand the impact of other procedural variations on bladder injury rates.