Background: This study aims to evaluate the effects of omission of the bladder\nflap formation at primary and repeat lower segment CS. Patients and\nMethods: The current study was randomized controlled trial conducted in\nWomen Health Hospital, Assiut University, Egypt between March 2017 and\nMay 2018 (ClinicalTrial.gov NCT03016273). Patients were divided into: Non\nbladder flap group: Uterine incision made 1 cm above the vesico-uterine reflection\nwithout incision and dissection of the bladder peritoneum and bladder\nflap group: Standard cesarean section technique with incision and dissection\nof a bladder flap prior to uterine incision. Results: The study included\n150 patients (75 in each arm). The most common indication for CS in both\ngroups was repeated CS. Non-bladder flap group, compared with flap group,\nshowed shorter skin-incision to delivery time and total operative time, and\nsignificantly lower mean estimated blood loss and postoperative pain score.\nNon-bladder flap group, compared with flap group, was more likely to\nshow postoperative microhematuria. The two groups required approximately\nthe same time for post-operative defecation. Conclusion: Omission\nof bladder flap formation during CS is associated with shorter operative\ntime, less blood loss, less postoperative pain and lower incidence of postoperative\nhematuria.
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