Bladder injuries associated with cesarean section.
ABSTRACT Bladder injury during cesarean section is unusual and may occur by failure to empty the bladder preoperatively, inadequate bladder flap reflection or incision into the vagina rather than the lower uterine segment. Three bladder injuries during cesarean section are reported. Although 2 women recovered normally 1 has persistent vesicoureteral reflux. With liberalization of indications for cesarean section bladder injuries may be seen more frequently.
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ABSTRACT: Objectives To determine the pelvic surgical operations resulting in urological injuries, to assess the different types of injuries and describe their management in the University Hospital Aristide Le Dantec of Dakar. Material and methods We did a retrospective study covering a period of eight years, reviewing the files of all patients who had urological injuries after pelvic surgery. The parameters studied were: age, the type of injury, the timing of diagnosis, the intervention responsible for the injury, the outcome after treatment. Results Twenty nine cases of urological injuries were diagnosed. The average age of our patients was 34,2 years +/-8,5 years; there was only one male patient. The average time to diagnosis was about seven weeks, and in 8 patients the diagnosis of injury was possible immediately. Caesarian section and hysterectomy were the predominant procedures responsible for injuries (37,93% and 34,48%, respectively). Section of ureter and vesicovaginal fistula represented 51,72% of all injuries (15 cases). The Results of reconstructive surgery where favorable in 82,75%(n = 24), two patients died after surgery of the complication. Conclusion The most frequent injuries were section of ureter and vesicovaginal fistula, often caused by gynecologic surgery.African Journal of Urology 12/2014;
- Australian and New Zealand Journal of Obstetrics and Gynaecology 06/1990; 30(2):184-5. · 1.62 Impact Factor
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ABSTRACT: Objective: Identify the risk factors for bladder injury during cesarean section. Material and methods: A case-control study was conducted at INPerIER with women undergoing cesarean section from 1 January 2001 to 31 December de 2007. The cases were women who had experienced bladder injury during the procedure; two women per case were selected as controls, who underwent cesarean section without bladder injury during the same period. The medical charts were reviewed for analysis and comparison of the demographic and clinical characteristics. Results: Among the 24,057 cesarean sections, 21 bladder injuries were found (incidence 0.087%), of which only 19 were analyzed. Previous cesarean was more frequent among the cases than among the controls (63% vs 42% p 0.134), with an Odds Ratio (OR) of 2.35 (CI 95% 0.759- 7.319); the OR was 3.75 (CI 95% 1.002- 14.07) when a history of cesarean section was compared to no history at all. Statistically significant differences (p< .05) were found for: gestational age (38.16 vs 37.35 weeks), one previous cesarean (42% vs 18%), adhesions (79% vs 5%), VBAC (31.5% vs 3%), midline incision (16% vs 68%), Pfannenstiel incision (84% vs 32%), bleeding (744 cc vs 509 cc), and surgery time (135 vs 58 minutes), for cases with and without bladder injury, respectively. No significant differences were found in mother's age, BMI, prior surgery, preterm labor, premature rupture of membranes, height of the fetus, chorioamnioitis, pre-induction, uterine incision, urgency of the procedure, or uterine rupture. The presence of adhesions had an OR of 67.5 (CI 95% 11.14- 408).