Risk Factor for Urinary Bladder Injury During Caesarean Section.

Objectives: During caesarean section (CS), the urinary bladder is at risk of getting injured due to its proximity to the uterus. Globally, with an upward trend in the CS rates, there is an upsurge in the complications associated with CS. Evaluating the risk factors of bladder injury will help in patient counseling and treating team preparedness, recognition, and remedial surgery. Materials and Method: This case-control study was conducted from January 2006 to December 2020. Eighteen subjects who had bladder injuries during CS from January 2006 to December 2020 were included in the study as cases. Subjects who had caesarean section without bladder injury (BI) were enrolled as controls. Two controls for each case were enrolled. Thirty-six controls were chosen as subjects who had a caesarean section before and after the case. The proforma was filled out for both cases and controls, with information on their demographics, obstetric history, intraoperative problems, and hospital stay. The type, size, and site of BI and detection time were recorded. Result: During the study period, 80,488 deliveries were conducted of which 32,022 caesarean sections (39.7%) were performed. Eighteen patients had BIs at the time of caesarean sections. Incidence of BI during caesarean section was 0.056% (18/32,022). Previous caesarean section, dense adhesions, and difficulty in forming a bladder flap were statistically significant risk factors for BI. Conclusion: Previous caesarean section is the most important risk factor for urinary BI during CS. Early detection and good repair have excellent prognosis. [ABSTRACT FROM AUTHOR]