Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Sep 30;9(9):4526-4529.
doi: 10.4103/jfmpc.jfmpc_586_20. eCollection 2020 Sep.

Cesarean bladder injury - obstetrician's nightmare

Pal Manidip  1 , Bandyopadhyay Soma  2
Affiliations
Review

Cesarean bladder injury - obstetrician's nightmare

Pal Manidip et al. J Family Med Prim Care. .

Abstract

Urinary bladder is an adjacent viscus susceptible for intraoperative injury during cesarean section (CS). Prolonged labor, scarred uterus, intraabdominal adhesion, emergency CS, advanced labor, cesarean hysterectomy etc., are the predisposing factors for bladder injury during CS. While operating on such conditions, one should be meticulous to explore the possibility of bladder injury. Family physician practicing community obstetrics should be aware of this and know how to tackle this. Usually the dome of the bladder is injured and the trigonal area remains away from the injury field by 6-10 cm. Bladder rent is repaired in two layers either by continuous simple or interrupted suture with 3-0 & 2-0 polyglycolic acid suture. Suprapubic cystostomy and transurethral catheter are kept for 10-14 days. While postoperative adhesion, CS during full dilatation of cervix, abnormal anatomy etc., may not proceed for negligence, bladder injury in normal patients and unrecognized intraoperative bladder injury may attract penalty from the consumer court.

Keywords: Cesarean section; injury; layer repair; medico-legal; urinary bladder.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Bladder injury repair done by simple continuous suturing with polyglycolic acid suture. First layer is bladder mucosa and muscularis layer (3-0) and second layer is serosa (2-0). Mucosa pierced through-&-through. Repair can be done by interrupted suturing also
See this image and copyright information in PMC

References

    1. Eisenkop SM, Richman R, Platt LD, Paul RH. Urinary tract injury during cesarean section. Obstet Gynecol. 1982;60:591–6. - PubMed
    1. AAFP-ACOG joint statement on cooperative practice and hospital privileges. [Last accessed on 2020 Mar 10]. Available from: https://wwwaafporg/about/policies/all/aafp-acoghtml .
    1. Recommended curriculum guidelines for family medicine residents. Maternity care AAFP Reprint No 261. [Last accessed on 2020 Mar 10]. Available from: https://wwwaafporg/dam/AAFP/documents/medical_education_residency/progra... .
    1. Peterson LE, Blackburn B, Phillips RL, Jr, Puffer JC. Structure and characteristics of family medicine maternity care fellowships. Fam Med. 2014;46:354–9. - PubMed
    1. Alanwar A, Al-Sayed HM, Ibrahim AM, Elkotb AM, Abdelshafy A, Abdelhadi R, et al. Urinary tract injuries during cesarean section in patients with morbid placental adherence: Retrospective cohort study. J Matern Fetal Neonatal Med. 2019;32:1461–7. - PubMed