Author(s)

Yasmeen A. Youssef, Tarek A. Farghaly, Elwany Elsenosy, Ahmed A. Youssef, Ahmed M. Abbas^*

Department of Obstetrics & Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.

Background: This study aims to evaluate the effects of omission of the bladder flap formation at primary and repeat lower segment CS. Patients and Methods: The current study was randomized controlled trial conducted in Women Health Hospital, Assiut University, Egypt between March 2017 and May 2018 (ClinicalTrial.gov NCT03016273). Patients were divided into: Non bladder flap group: Uterine incision made 1 cm above the vesico-uterine reflection without incision and dissection of the bladder peritoneum and bladder flap group: Standard cesarean section technique with incision and dissection of a bladder flap prior to uterine incision. Results: The study included 150 patients (75 in each arm). The most common indication for CS in both groups was repeated CS. Non-bladder flap group, compared with flap group, showed shorter skin-incision to delivery time and total operative time, and significantly lower mean estimated blood loss and postoperative pain score. Non-bladder flap group, compared with flap group, was more likely to show postoperative microhematuria. The two groups required approximately the same time for post-operative defecation. Conclusion: Omission of bladder flap formation during CS is associated with shorter operative time, less blood loss, less postoperative pain and lower incidence of postoperative hematuria.

Cesarean Section, Bladder Flap, Hematuria, Lower Segment

Youssef, Y. , Farghaly, T. , Elsenosy, E. , Youssef, A. and Abbas, A. (2019) The Effect of Omission of the Bladder Flap Formation at Lower Segment Cesarean Delivery: A Randomized Controlled Trial. Open Journal of Obstetrics and Gynecology, 9, 1083-1091. doi: 10.4236/ojog.2019.98105.