Abstract
Introduction
Creation of the bladder flap, i.e., dissecting the urinary bladder from the lower segment of the uterus is a standard part of cesarean section (CS). However, it is yet to be established whether the formation of bladder flap is advantageous.
Review of literature
Pelosi and Ortega in 1994 introduced a new minimally invasive technique of CS, which included the omission of bladder dissection together with other modifications. Omission of the bladder flap provides short-term benefits such as reduction of operating time and incision-delivery interval, wound infection, reduced blood loss and analgesic requirement. In addition, it is associated with good long-term outcomes with regards to adhesion formation.
Conclusion
Further large-scale controlled randomized clinical trials are needed to investigate the safety of this technique with respect to in deeply engaged head, preterm, subsequent pregnancies and trial of labor and also to determine the future role of this technique that will contribute to advancement and popularity of this technique amongst obstetricians.
Similar content being viewed by others
References
Hohlagschwandtner M, Ruecklinger E, Husslein P, Joura E (2001) Is the formation of a bladder flap at Cesarean necessary? A randomized trial. Obstet Gynecol 98:1089–1092. doi:10.1016/S0029-7844(01)01570-8
Pelosi M, Ortega I (1994) Cesarean section: Pelosi’s simplified technique. Rev Chil Obstet Ginecol 59(5):372–377
Wood R, Simon H (1999) Oz Ali-Utku. Pelosi-Type vs. traditional cesarean delivery. A prospective comparison. J Reprod Med 44:788–795
Chigbu C, Ezeome I, Iloabachie G (2006) Non-formation of bladder flap at cesarean section. Int J Gynaecol Obstet 95:284–285. doi:10.1016/j.ijgo.2006.08.010
Soper D, Brockwell W, Dalton H (1992) The importance of wound infection in antibiotic failures in the therapy of postpartum endometritis. Surg Gynecol Obstet 174:256
Burke J II, Gallup D (2003) Incisions for gynaecologic surgery. In: Rock JA, Jones HW III (eds) Telinde’s operative gynaecology. Lippincott Williams and Wilkins, Philadelphia, pp 255–290
Murphy K (1999) Reducing the complications of cesarean section. In: Bonnar J (ed) Recent advances in obstetrics and gynaecology. Churchill Livingstone, London, p 144
Eisenkop S, Richman R, Platt L, Paul R (1982) Urinary tract injury during cesarean section. Obstet Gynecol 60:591–596
Rajasekar D, Hall M (1997) Urinary tract injuries during obstetric intervention. Br J Obstet Gynaecol 104:731–734
Narayan H, Taylor D (1994) The role of caesarean section in the delivery of the very preterm infant. Br J Obstet Gynaecol 101:936–938
Jelsema R, Wittingen J, Vander Kolk K (1993) Continuous, nonlocking, single-layer repair of the low transverse uterine incision. J Reprod Med 38:393–396
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mahajan, N.N. Justifying formation of bladder flap at cesarean section?. Arch Gynecol Obstet 279, 853–855 (2009). https://doi.org/10.1007/s00404-008-0838-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-008-0838-6