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