TY - JOUR
T1 - Urinary bladder injury during cesarean delivery
T2 - risk factors and the role of retrograde bladder filling
AU - Chill, Henry H.
AU - Karavani, Gilad
AU - Reuveni-Salzman, Adi
AU - Lipschuetz, Michal
AU - Shimonovitz, Tzvika
AU - Cohen, Nir
AU - Shveiky, David
N1 - Publisher Copyright:
© 2021, The International Urogynecological Association.
PY - 2021/7
Y1 - 2021/7
N2 - Introduction and hypothesis: Urinary bladder injury during cesarean delivery is an uncommon complication with substantial maternal morbidity. The aim of this study was to identify possible risk factors for bladder injury during cesarean delivery and to describe the role of retrograde bladder filling in the assessment of bladder wall integrity. Methods: A retrospective cohort study at a large tertiary referral center. Women who underwent cesarean delivery between 2003 and 2017 were included. Women diagnosed with urinary bladder injury were compared to women who did not have such injuries. Data retrieved included demographic characteristics, general medical history, obstetric history and intra-partum and intra-operative data. Information regarding use of retrograde bladder filling intra-operatively was retrieved as well. Results: During the study period, 21,177 cesarean deliveries were performed of which 68 (0.3%) cases of urinary bladder injury were identified. Two-thirds of injuries were located at the urinary bladder dome with the remaining third located at the posterior bladder wall. Most injuries were formed during uterine incision extension (60.0%) followed by peritoneal entry (22.0%). Following uni- and multivariate analyses, three parameters remained independent risk factors for bladder injury: urinary bladder adhesions, failed vacuum attempt prior to cesarean delivery and size of the uterine incision extension. In 15.4% of cases in which retrograde bladder filling was utilized following bladder repair, leakage of fluid was evident. Conclusion: Urinary bladder adhesions, failed vacuum attempt prior to cesarean delivery and size of uterine incision extension are independent risk factors for urinary bladder injury during cesarean delivery.
AB - Introduction and hypothesis: Urinary bladder injury during cesarean delivery is an uncommon complication with substantial maternal morbidity. The aim of this study was to identify possible risk factors for bladder injury during cesarean delivery and to describe the role of retrograde bladder filling in the assessment of bladder wall integrity. Methods: A retrospective cohort study at a large tertiary referral center. Women who underwent cesarean delivery between 2003 and 2017 were included. Women diagnosed with urinary bladder injury were compared to women who did not have such injuries. Data retrieved included demographic characteristics, general medical history, obstetric history and intra-partum and intra-operative data. Information regarding use of retrograde bladder filling intra-operatively was retrieved as well. Results: During the study period, 21,177 cesarean deliveries were performed of which 68 (0.3%) cases of urinary bladder injury were identified. Two-thirds of injuries were located at the urinary bladder dome with the remaining third located at the posterior bladder wall. Most injuries were formed during uterine incision extension (60.0%) followed by peritoneal entry (22.0%). Following uni- and multivariate analyses, three parameters remained independent risk factors for bladder injury: urinary bladder adhesions, failed vacuum attempt prior to cesarean delivery and size of the uterine incision extension. In 15.4% of cases in which retrograde bladder filling was utilized following bladder repair, leakage of fluid was evident. Conclusion: Urinary bladder adhesions, failed vacuum attempt prior to cesarean delivery and size of uterine incision extension are independent risk factors for urinary bladder injury during cesarean delivery.
KW - Bladder repair
KW - Cesarean delivery
KW - Cesarean section
KW - Urinary bladder injury
UR - http://www.scopus.com/inward/record.url?scp=85098494618&partnerID=8YFLogxK
U2 - 10.1007/s00192-020-04630-9
DO - 10.1007/s00192-020-04630-9
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C2 - 33386865
AN - SCOPUS:85098494618
SN - 0937-3462
VL - 32
SP - 1801
EP - 1806
JO - International Urogynecology Journal
JF - International Urogynecology Journal
IS - 7
ER -