Could Bladder Inflation Prior to Cesarean Section Prevent Urinary Tract Injury in High Risk Group? A Randomized Controlled Trial

Ali, Ahmed M.; Ahmed, Moussa Mahdi; Khodry, Mustafa M.; Abbas, Ahmed M.

doi:10.4236/ojog.2019.92021

Cited by 2 publications

(14 citation statements)

References 22 publications

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“…However, the incidence of bladder injury exclusively with dense pelvic adhesions is not available. In the study of full bladder conducted on difficult C-section cases, the bladder injury rate was 18.4% in the control group which is quite comparable to our study 16 . Furthermore, the threshold of surgeon for dense adhesions, classification system used and expertise of the surgeon to perform adhesiolysis are other factors which may have influenced the incidence of bladder injury.…”

Section: Discussionsupporting

confidence: 88%

“…In this study, bladder retrofill has proved useful to prevent bladder injury. A recent study of women with multiple C-sections, including cases of placenta previa, has also reported a significant reduction in bladder injury with a full bladder 16 . The same results have been observed in a retrospective study of laparoscopic gynaecological surgery with complete prevention of bladder injury with cystoinsufflation using CO 2 26 .…”

Section: Discussionmentioning

confidence: 92%

“…Bladder injury is the commonest complication of multiple C-sections. With each subsequent C-section, the adhesions become denser and the risk of bladder injury is also increased (0.6% vs 0.19%) 16 , 17 . The attempts to prevent adhesion formation by different methods like hydroflotation, absorbable and non-absorbable membranes, derivative gel etc.…”

Section: Discussionmentioning

confidence: 99%

“…The Bladder deflation by preoperative insertion of urinary catheter is a routine practice to prevent bladder injury during C-section 3,22 . However, recent studies are pointing out towards the safety of C-section without the catheter 16,[23][24][25] . www.nature.com/scientificreports/ In this study, bladder retrofill has proved useful to prevent bladder injury.…”

Section: Strength and Limitations Of The Study Cystoinflation Or Blamentioning

confidence: 99%

“…The adhesions are a major risk factor for bladder injury 15 . The routine practice of preoperative insertion of urinary catheter improves visualization in the operative field but fails to prevent bladder injury in dense adhesions 16 . Dye test with methylene blue is one of the methods used to identify bladder injury 3 .…”

Section: Introductionmentioning

confidence: 99%

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A randomized controlled trial of cystoinflation to prevent bladder injury in the adhesive disease of multiple caesarean sections

Saaqib

Iqbal

Naheed

et al. 2020

Sci Rep

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Caesarean sections carry the risk of urinary bladder injury due to formation of adhesions obscuring pelvic planes. Visualizing bladder during retro-fill (cystoinflation) makes it recognizable as it rises into the abdomen taking a tense rounded contour. We conducted a prospective randomized controlled trial to find out whether improved identification of bladder margins by cystoinflation could decrease bladder injury rate and blood loss without causing urological complications. This study included 214 healthy women with previous operative deliveries undergoing elective caesarean section and found to have dense pelvic adhesions. The subjects were randomly allocated into cystoinflation and control groups. Adhesiolysis was performed using bladder retro-fill with 300 cc saline in cystoinflation group, and without retro-fill in control. The bladder injury rate was significantly lower in cystoinflation group compared to control (2.8% vs 20.6%, P < .0001) with lesser blood loss in cystoinflation group (585.33 cc vs 797.10 cc, P < .0001). Mean operative time was similar in both groups. Urinary tract infection and micturition problems occurred more frequently in control group than cystoinflation group (16.8% vs 1.9%, P = .001 and .47 ± 1.63% vs 077 ± .633%, P = .021 respectively) with fistula in one subject compared to none in cystoinflation group. In this study, cystoinflation was effective to significantly reduce bladder injury rate and blood loss. This technique may also prove useful in the fields of surgery, urology and urogynecology.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Strength and Limitations Of The Study Cystoinflation Or Blamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A randomized controlled trial of cystoinflation to prevent bladder injury in the adhesive disease of multiple caesarean sections

Saaqib

Iqbal

Naheed

et al. 2020

Sci Rep

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Use of Cystoinflation to Prevent Urinary Tract Injuries in Patients with Placenta Previa

Uzma Hussain,

Faryal Kanwal,

Muhammad Essa

et al. 2024

biosight

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Introduction: There is insufficient evidence to support the use of cystoinflation to prevent bladder injury in women with placenta previa. The purpose of this study is to find the effectiveness and safety of cystoinflation to prevent bladder injury in women with placenta previa. Methods: The study was conducted at Gynecology & Obstetrics Department, lady Willing-don hospital, Lahore for six months duration . The research was conducted by forming two groups. Women in Group-A (inflated urinary bladder) had significantly lower bladder injury as compared to women in Group-B (deflated urinary bladder). i.e. 1.9% vs. 11.32%, p-value=0.050. Results: Homeostatic sutures requirement was significantly higher in Group-B as that of Group-A. i.e. 15.1% vs. 18.9%, p-value=0.604 Duration of hospital stay showed no significant difference between groups. i.e. 96.2% patients in Group-A and 88.7% patients in Group-B discharged from hospital within 3-4 days. Conclusion: Based on the results of this study, women presenting with placenta previa had significantly lower incidences of bladder injury as a result of cystoinflation during cesarean section.

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Could Bladder Inflation Prior to Cesarean Section Prevent Urinary Tract Injury in High Risk Group? A Randomized Controlled Trial

Cited by 2 publications

References 22 publications

A randomized controlled trial of cystoinflation to prevent bladder injury in the adhesive disease of multiple caesarean sections

A randomized controlled trial of cystoinflation to prevent bladder injury in the adhesive disease of multiple caesarean sections

Use of Cystoinflation to Prevent Urinary Tract Injuries in Patients with Placenta Previa

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