Our Summary

This research aims to review the occurrence of bladder and ureter (the tubes that carry urine from the kidneys to the bladder) injuries that happen during caesarean sections (C-section) and hysterectomies (surgery to remove a woman’s uterus). The researchers looked at multiple studies that reported the rates of these injuries during these procedures.

The research found that out of 100,000 women who undergo a C-section, 267 experience bladder injuries and 9 experience ureter injuries. The number of injuries during hysterectomies varies by the type of technique used and the specific condition being treated. For example, during certain types of hysterectomies, the rate of bladder injuries ranges from 212 to 997 per 100,000 procedures. The rate of ureter injuries is 9 to 577 per 100,000 procedures.

These rates were higher in certain conditions, such as open peripartum hysterectomy (surgery performed after childbirth), where the rate of bladder injuries was 6,279 per 100,000 procedures and the rate of ureter injuries was 666 per 100,000. Similarly, during laparoscopic hysterectomy for cancer, the rate of bladder injuries was 1,553 per 100,000 and the rate of ureter injuries was 814 per 100,000 procedures.

The main risk factor for these injuries was the surgeon’s lack of experience. The most effective way to prevent these injuries was found to be improved knowledge of anatomy. The researchers suggest that doctors should inform their patients of the risks, identify potential risk factors and take steps to prevent these injuries.

FAQs

  1. What is the rate of bladder and ureter injuries during C-sections according to the research?
  2. How does the occurrence of bladder and ureter injuries vary during different types of hysterectomies?
  3. What factors increase the risk of bladder and ureter injuries during these procedures and how can they be prevented?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cesarean section is to ensure they are fully informed about the potential risks and complications associated with the procedure, including the possibility of bladder or ureter injuries. It is important for patients to discuss any concerns or questions they may have with their healthcare provider prior to the surgery. Additionally, patients should follow their doctor’s instructions for post-operative care and attend all follow-up appointments to monitor for any signs of complications.

Suitable For

Based on this research, patients who are recommended for a cesarean section are typically those who have certain medical conditions or factors that may increase the risk of bladder or ureter injuries during the procedure. These may include:

  • Women undergoing open peripartum hysterectomy
  • Women undergoing laparoscopic hysterectomy for cancer
  • Women with a history of previous pelvic surgery
  • Women with a history of pelvic inflammatory disease
  • Women with certain gynecological conditions that require a hysterectomy
  • Women with a high BMI
  • Women with complex pelvic anatomy
  • Women with certain medical conditions that may increase the risk of surgical complications

It is important for healthcare providers to carefully assess each patient’s individual risk factors and discuss the potential risks and benefits of a cesarean section before recommending the procedure. Additionally, steps should be taken to minimize the risk of bladder and ureter injuries during the surgery, such as ensuring the surgeon has sufficient experience and knowledge of anatomy.

Timeline

Before a cesarean section, a patient may experience complications during pregnancy or labor that necessitate the need for a C-section. This could include issues such as fetal distress, placenta previa, or failure to progress in labor. The decision to have a C-section is typically made by the healthcare provider in consultation with the patient.

During the C-section procedure, the patient will be given anesthesia to numb the lower half of their body. The surgeon will make an incision in the abdomen and uterus to deliver the baby. The procedure usually takes around 45 minutes to an hour.

After the C-section, the patient will be monitored closely for any complications such as infection, blood clots, or excessive bleeding. They will typically stay in the hospital for 2-4 days to recover before being discharged.

In the weeks following the C-section, the patient will need to take it easy and avoid heavy lifting or strenuous activity. They may experience discomfort at the incision site, as well as fatigue and difficulty moving around. It is important for the patient to follow their healthcare provider’s instructions for post-operative care to ensure a smooth recovery.

Overall, a cesarean section is a major surgical procedure that comes with risks and potential complications. However, in many cases, it is necessary to ensure the health and safety of both the mother and the baby.

What to Ask Your Doctor

  1. What is the rate of bladder and ureter injuries during a C-section?
  2. What is the rate of bladder and ureter injuries during a hysterectomy?
  3. What are the risk factors for bladder and ureter injuries during these procedures?
  4. How can these injuries be prevented?
  5. How experienced is the surgeon who will be performing the procedure?
  6. What steps will be taken during the procedure to minimize the risk of bladder and ureter injuries?
  7. What are the signs and symptoms of bladder and ureter injuries that I should watch out for after the procedure?
  8. What is the treatment for bladder and ureter injuries if they occur during the procedure?
  9. Are there any long-term effects of bladder and ureter injuries that I should be aware of?
  10. Are there any alternative procedures that may have a lower risk of bladder and ureter injuries?

Reference

Authors: Wei G, Harley F, O’Callaghan M, Adshead J, Hennessey D, Kinnear N. Journal: Int Urogynecol J. 2023 Feb;34(2):371-389. doi: 10.1007/s00192-022-05339-7. Epub 2022 Oct 17. PMID: 36251061