Overview of Intraoperative Injuries of the Urinary Tract System during Caesarean section

Main Article Content

Ali El-Shabrawy Ali, Wael Sabry Noseir , Ahmed Ismail Mohamed, Basma El-Sayed Kamar

Keywords

Intraoperative Injuries; Caesarean section; Urinary Tract injury

Abstract

Urologic injury is the most common injury at the time of either obstetric or gynecologic surgery, with the bladder being the most frequent organ damaged. Risk factors for bladder injury during cesarean section include previous cesarean delivery, adhesions, emergent cesarean delivery, and cesarean section performed at the time of the second stage of labor.  Most bladder injuries are recognized at the time of surgery, which is important, as quick recognition and repair are associated with a significant reduction in patient mortality. Although cesarean delivery is a cornerstone of obstetrics, there is a paucity of data in the literature either supporting or refuting specific techniques that are performed today. Damage to the urinary tract, which is a complication of caesarean section, is rarely described in the literature. There is also no evidence that supports the creation of a bladder flap, although routinely performed during cesarean section, as a method to reduce the risk of bladder injury.


Therefore, the aim of the present study was to evaluate the factors, diagnosis and treatment of the urinary tract injury during caesarean section.

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References

1- Radu, V. D., Pristavu, A. I., Vinturache, A., Onofrei, P., Socolov, D. G., Carauleanu, A., ... & Costache, R. C. (2022). Risk Factors for Urological Complications Associated with Caesarean Section—A Case-Control Study. Medicina, 58(1), 123.‏
2- Ghaffar, S., Shaheen, T., Ghaffar, B., Ghaffar, S., Haq, H., & Khawar, F. (2021). Operative Morbidities among Patients with Previous Caesarean Sections. Journal of Islamic International Medical College (JIIMC), 16(3), 176-179.‏
3- Blackwell, R. H., Kirshenbaum, E. J., Shah, A. S., Kuo, P. C., Gupta, G. N., & Turk, T. M. (2018). Complications of recognized and unrecognized iatrogenic ureteral injury at time of hysterectomy: a population based analysis. The Journal of urology, 199(6), 1540-1545.‏
4- Varlas, V. N., Rhazi, Y., Bors, R. G., Penes, O., & Radavoi, D. (2021). The urological complications of vaginal birth after cesarean (VBAC)–a literature review. Journal of Medicine and Life, 14(4), 443.‏
5- Naicker, S., Naidoo, T. D., & Moodley, J. (2020). Obstetric-associated lower urinary tract injuries: A case series from a tertiary centre in a low-resource setting. Case Reports in Women's Health, 27, e00218.‏
6- Phillips, B., Holzmer, S., Turco, L., Mirzaie, M., Mause, E., Mause, A., ... & Asensio, J. A. (2017). Trauma to the bladder and ureter: a review of diagnosis, management, and prognosis. European Journal of Trauma and Emergency Surgery, 43, 763-773.‏
7- Jensen, A. S., & Rudnicki, M. (2023). Iatrogenic bladder and ureteral injuries following gynecological and obstetric surgery. Archives of Gynecology and Obstetrics, 307(2), 511-518.‏
8- Collins, S. L., Alemdar, B., van Beekhuizen, H. J., Bertholdt, C., Braun, T., Calda, P., ... & Chantraine, F. (2019). Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta. American journal of obstetrics and gynecology, 220(6), 511-526.‏
9- Saaqib, S., Iqbal, A., Naheed, M., Saeed, T., & Khalid, M. (2020). A randomized controlled trial of cystoinflation to prevent bladder injury in the adhesive disease of multiple caesarean sections. Scientific Reports, 10(1), 15297.‏
10- Korniluk, A., Kosiński, P., & Wielgoś, M. (2017). Intraoperative damage to the urinary bladder during cesarean section—literature review. Ginekologia polska, 88(3), 161-165.‏
11- Leong, J. Y., Schultz, J., Zhan, T., Marks, J. A., & Chung, P. H. (2022). General surgeons’ comfort and urologists’ perceptions of bladder trauma management. The Canadian Journal of Urology, 29(2), 11102.‏
12- Rajasekar, D., & Hall, M. (1997). Urinary tract injuries during obstetric intervention. BJOG: An International Journal of Obstetrics & Gynaecology, 104(6), 731-734.‏
13- Phipps, M. G., Watabe, B., Clemons, J. L., Weitzen, S., & Myers, D. L. (2005). Risk factors for bladder injury during cesarean delivery. Obstetrics & Gynecology, 105(1), 156-160.
14- ‏Dauleh, W., Al Sakka, M., & Shahata, M. (2006). Urinary tract injuries during caesarean section. Qatar Medical Journal, 2006(2), 8.‏
15- Raut, V., Shrivastava, A., Nandanwar, S., & Bhattacharya, M. (1991). Urological injuries during obstetric and gynaecological surgical procedures. Journal of Postgraduate Medicine, 37(1), 21.‏
16- Başaranoğlu, S., Deregözü, A., Köroğlu, N., Kalkan, M., Şahin, C., & KADANALI, S. (2016). Early and late diagnosis of iatrogenic urinary tract injuries during obstetric and gynecological operations. Journal of Clinical and Experimental Investigations, 7(3), 252-257.‏
17- Sikora-Szczesniak, D. L. (2017). Injury to Urinary Organs during Natural Deliveries, Caesarean Sections and Peripartum Hysterectomies. Med Sur Urol, 6(195), 2.‏
18- M El-Mogy, A. A., G Abd El-Raouf, A., G Ayad, A., & M Abd El-Aal, H. (2021). Iatrogenic urinary tract injury in obstetric and gynecological procedures: five-year-experience from two university hospitals. Al-Azhar Medical Journal, 50(1), 153-162.‏
19- Chill, H. H., Karavani, G., Reuveni-Salzman, A., Lipschuetz, M., Shimonovitz, T., Cohen, N., & Shveiky, D. (2021). Urinary bladder injury during cesarean delivery: risk factors and the role of retrograde bladder filling. International Urogynecology Journal, 1-6.‏
20- Alanwar, A., Al-Sayed, H. M., Ibrahim, A. M., Elkotb, A. M., Abdelshafy, A., Abdelhadi, R., ... & Nawara, M. (2019). Urinary tract injuries during cesarean section in patients with morbid placental adherence: retrospective cohort study. The Journal of Maternal-Fetal & Neonatal Medicine, 32(9), 1461-1467.‏
21- M Tarney, C. (2013). Bladder injury during cesarean delivery. Current women's health reviews, 9(2), 70-76.‏
22- Rahman, M. S., Gasem, T., Al Suleiman, S. A., Al Jama, F. E., Burshaid, S., & Rahman, J. (2009). Bladder injuries during cesarean section in a University Hospital: a 25-year review. Archives of gynecology and obstetrics, 279, 349-352.‏
23- Gungorduk, K., Asicioglu, O., Celikkol, O., Sudolmus, S., & Ark, C. (2010). Iatrogenic bladder injuries during caesarean delivery: a case control study. Journal of Obstetrics and Gynaecology, 30(7), 667-670.‏
24- Alcocer Urueta, J., Bonilla Mares, M., Gorbea Chávez, V., & Velázquez Valassi, B. (2009). Factores de riesgo asociados a lesiones vesicales en cesárea. Actas Urológicas Españolas, 33(7), 806-810.‏
25- Makoha, F. W., Fathuddien, M. A., & Felimban, H. M. (2006). Choice of abdominal incision and risk of trauma to the urinary bladder and bowel in multiple cesarean sections. European Journal of Obstetrics & Gynecology and Reproductive Biology, 125(1), 50-53.‏
26- Glaser, L. M., & Milad, M. P. (2019). Bowel and bladder injury repair and follow-up after gynecologic surgery. Obstetrics & Gynecology, 133(2), 313-322.‏
27- Joodi, M. R., & Al-Hussainy, A. F. (2020). Lower urinary system injuries in association with previous repeated caesarian sections: Cross sectional study. Annals of Tropical Medicine and Public Health, 23(1), S413.‏