PMID- 28411456
OWN - NLM
STAT- MEDLINE
DCOM- 20180302
LR  - 20180302
IS  - 1872-7654 (Electronic)
IS  - 0301-2115 (Linking)
VI  - 213
DP  - 2017 Jun
TI  - Urinary bladder injury during cesarean delivery: Maternal outcome from a
      contemporary large case series.
PG  - 26-30
LID - S0301-2115(17)30159-8 [pii]
LID - 10.1016/j.ejogrb.2017.04.007 [doi]
AB  - BACKGROUND: Urinary bladder injury is a rare complication during cesarean
      delivery. Little is known on maternal outcome following this injury. OBJECTIVE:
      To evaluate short and long-term maternal outcome following bladder injury during 
      cesarean delivery. STUDY DESIGN: A retrospective case series of all pregnancies
      complicated by full-thickness bladder injury during cesarean delivery in a single
      university affiliated tertiary medical center (August 2007-June 2016). Data on
      demographics, labor and surgery parameters, postpartum sequelae, and cystography 
      were collected and reviewed by study personnel. Short-term maternal outcome
      included catheterization period, cystography results (if performed), any febrile 
      illness and/or need for second operation prior to maternal discharge. Long term
      maternal outcome was obtained by searching our urology departmental and
      ambulatory database for follow up for all women. Univariate analysis was used to 
      compare maternal outcome following first or repeat cesarean delivery. RESULTS: Of
      17,326 cesarean deliveries performed during study period, 81 (0.47%) were
      complicated by bladder injury. Of them, 8 cases (9.9%) occurred during primary
      cesarean delivery (overall risk in primary cesarean 0.07%). Of the other 73 cases
      that followed repeated cesarean, adhesions were documented in 55 (75.3%) of them.
      Six cases (8.2%) had placenta accreta. Bladder injury occurred at peritoneal
      entry in 55 (67.9%) cases, and involved the bladder dome in 49 (60.5%) of them.
      Injury was diagnosed during cesarean delivery in all but 3 women, in whom
      abdominal pain and bloating prompted evaluation on first to third postoperative
      day. All 3 underwent re-laparotomy with bladder closure without further adverse
      sequelae. Cystography was performed in 35 patients on median postoperative day 8 
      (6-11 days). Eleven patients had abnormal findings as follows: 5 urinary leakage,
      4 bladder wall irregularity and two urinary reflux. Two of the 11 patients (18%) 
      required additional interventions: One patient required bilateral nephrostomy and
      re-laparotomy for bladder closure followed by additional surgery to repair
      consequent vesico-vaginal fistula. The second patient required left nephrostomy
      and ureteral re-implantation. Both women had combined ureteral and bladder
      injury. For the rest of the cohort, no febrile illness or other short- or
      long-term adverse events were reported. There were no clinically significant
      differences in adverse maternal outcomes between women with repeat cesarean
      delivery compared to primary cesarean delivery. CONCLUSION: Bladder injury is a
      rare complication of cesarean delivery. In our case series, unless there is
      combined ureteral and bladder injury, prognosis was favorable without any
      long-term sequelae.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Salman, Lina
AU  - Salman L
AD  - Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women,
      Rabin Medical Center, Petach Tikva, Israel(1).
FAU - Aharony, Shachar
AU  - Aharony S
AD  - Urology Service, Rabin Medical Center, Petach Tikva, Israel(1).
FAU - Shmueli, Anat
AU  - Shmueli A
AD  - Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women,
      Rabin Medical Center, Petach Tikva, Israel(1).
FAU - Wiznitzer, Arnon
AU  - Wiznitzer A
AD  - Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women,
      Rabin Medical Center, Petach Tikva, Israel(1).
FAU - Chen, Rony
AU  - Chen R
AD  - Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women,
      Rabin Medical Center, Petach Tikva, Israel(1).
FAU - Gabbay-Benziv, Rinat
AU  - Gabbay-Benziv R
AD  - Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera,
      Israel(2). Electronic address: gabbayrinat@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20170405
PL  - Ireland
TA  - Eur J Obstet Gynecol Reprod Biol
JT  - European journal of obstetrics, gynecology, and reproductive biology
JID - 0375672
SB  - IM
MH  - Adult
MH  - Cesarean Section/*adverse effects
MH  - Cesarean Section, Repeat/adverse effects
MH  - Cystography
MH  - Female
MH  - Humans
MH  - Pregnancy
MH  - Prognosis
MH  - Retrospective Studies
MH  - Urinary Bladder/*injuries/pathology/surgery
MH  - Urinary Bladder Diseases/epidemiology/etiology
MH  - Vesicovaginal Fistula
OTO - NOTNLM
OT  - Bladder injury
OT  - Cesarean complications
OT  - Cesarean delivery
EDAT- 2017/04/16 06:00
MHDA- 2018/03/03 06:00
CRDT- 2017/04/16 06:00
PHST- 2017/03/24 00:00 [received]
PHST- 2017/03/29 00:00 [revised]
PHST- 2017/04/04 00:00 [accepted]
PHST- 2017/04/16 06:00 [pubmed]
PHST- 2018/03/03 06:00 [medline]
PHST- 2017/04/16 06:00 [entrez]
AID - S0301-2115(17)30159-8 [pii]
AID - 10.1016/j.ejogrb.2017.04.007 [doi]
PST - ppublish
SO  - Eur J Obstet Gynecol Reprod Biol. 2017 Jun;213:26-30. doi:
      10.1016/j.ejogrb.2017.04.007. Epub 2017 Apr 5.