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December 2011 · Vol. 23, No. 12

Editorial

How to repair bladder injury at the time of cesarean delivery

You’re well-trained to take primary responsibility for repair of most of these urinary tract injuries.


INSTANT POLL

During a cesarean delivery, you encountered a simple 5-cm laceration in the dome of the bladder. Are you willing to repair it without consultation with a senior obstetrician, urologist, or urogynecologist?

Click here

Robert  L.  Barbieri,  MD

Editor in Chief
ROBERT.BARBIERI@QHC.COM



CASE: “Oops! I nicked her bladder”

You are performing the fourth cesarean delivery on your patient, a 30-year-old G4P3. The abdominal and uterine incisions go well, and delivery is uneventful. As you prepare to close the uterus, you notice that there is a hole in the bladder 5 cm long. You realize that the injury likely occurred before you made the uterine incision, at the time you mobilized the bladder from the lower uterine segment.
Now, how will you repair the injury to the bladder?

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