Management of Bladder Injury During Caesarean Delivery and Long-Term Results

Abstract

Abstract Purpose: The urinary bladder injury after cesarean delivery is rare but significant. This study aims to evaluate the management of bladder injuries after cesarean section and long-term postoperative results. Methods: Our study included 67 patients who had bladder injuries after cesarean section and underwent repair. Patients with non-bladder genitourinary organ injuries and/or injuries other than those associated with cesarean delivery were excluded. The patients’ demographic records and pre- and postoperative data were evaluated retrospectively. Results: Between September 2018 and February 2023, 123,296 pregnant women were admitted to our hospital for birth; 46,786 (38%) cesarean deliveries occurred, and 67 patients suffered bladder injuries (0.14%). Diagnosis was made intraoperatively in 58 patients and postoperatively in 9 patients. The average age of the patients was 33,8 years and the average number of cesarean sections the patients had undergone was 3,2. The average bladder defect size was 4,4 cm, and they were most frequently observed in the bladder dome. When evaluated in the early period (first month postpartum) and late period (after the first month), lower urinary tract symptoms were observed in a total of 16 patients, and the most common symptom was dysuria. Conclusions: Bladder injury during cesarean delivery is a rare but serious condition. When bladder injury is suspected, diagnosis and treatment should be done promptly to minimize complications. Our study draws attention to this topic, and prospective studies with larger populations and longer follow-up periods are needed to obtain more conclusive results.