TITLE:
Could Bladder Inflation Prior to Cesarean Section Prevent Urinary Tract Injury in High Risk Group? A Randomized Controlled Trial
AUTHORS:
Abd El-Naser Abd El-Gaber Ali, Mohammad A. M. Ahmed, Mustafa M. Khodry, Ahmed M. Abbas
KEYWORDS:
Bladder Inflation, Urinary Tract Injury (UTI), Cesarean Section (CS)
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.2,
February
15,
2019
ABSTRACT: 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 0.01; 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 There was a highly statistically significant difference between group I
and group II as regard to hospital stay (p 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.