Author(s)

Abd El-Naser Abd El-Gaber Ali^1*, Mohammad A. M. Ahmed¹, Mustafa M. Khodry¹, Ahmed M. Abbas²

¹Department of Obstetrics & Gynecology, Faculty of Medicine, South Valley University, Qena, Egypt.
²Department of Obstetrics & Gynecology, Faculty of Medicine, Assiut University, Asyut, Egypt.

Background: Accidental urinary tract particularly bladder injury during cesarean delivery has a significant maternal morbidity, as it may lead to extended operative time, infection of urinary tract and sometimes development of urinary tract fistulae. Objective: To find out the efficacy of urinary bladder inflation immediately prior to cesarean section (CS) procedure in minimizing incidence of accidently urinary tract injury in high risk patients. Setting: Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Qena, Egypt. Duration: From August 2017 to November 2018. Study Design: A prospective randomized controlled trial. Methods: Seventy six pregnant women recruited from attendants of outpatient antenatal care unit of obstetrics and gynecology department who planned for cesarean delivery and carried one or more risk factors for urinary tract injury. Patients randomly were classified into 2 groups (group I included 38 cases, underwent bladder inflation using triple way Foley’s catheter immediately before CS and group II included 38 cases, and underwent bladder deflation with 2 ways Foley’s catheter immediately before CS. Results: The overall incidence of urinary tract injury was significantly higher in group II (7 cases = 18.4%) than in group I (2 cases = 5.2%) with p value < 0.001. The incidence of urinary bladder injury was moderately significantly higher in group II (5 cases = 13.1%) than group I (2 cases = 5.2%) with p value < 0.01; ureteric or combined vesico-ureteric injuries had been reported only in group II (1 case = 2.6% and 1 case = 2.6%) respectively with no case reported in group I (p < 0.001). There was a highly statistically significant difference between group I and group II as regard to hospital stay (p < 0.001) but mildly significant differences in operative time and remote urinary tract fistulae (p < 0.05). Conclusions: There was significant reduction in urinary bladder injury, ureteric injury, operative time and hospital stay. Urinary bladder inflation immediately before cesarean section should be applied in patients who have any risk factor of dense bladder adhesion as a protective procedure against urinary tract injuries.

Bladder Inflation, Urinary Tract Injury (UTI), Cesarean Section (CS)

Ali, A. , Ahmed, M. , Khodry, M. and Abbas, A. (2019) Could Bladder Inflation Prior to Cesarean Section Prevent Urinary Tract Injury in High Risk Group? A Randomized Controlled Trial. Open Journal of Obstetrics and Gynecology, 9, 207-215. doi: 10.4236/ojog.2019.92021.