The Effect of Cystodistention During Cesarean Section for Preventing Urinary Bladder Injuries in Patients with Placenta Previa

Background: Adhesions from prior procedures greatly enhance the risk of bladder damage during emergency cesarean sections. One technique to minimize bladder injuries during cesarean sections is cystodistention or bladder retro-fill, which inflates the bladder to improve its visualization and facilitate dissection. This study aimed to assess the safety and effectiveness of cystodistention in preventing bladder injuries among women diagnosed with placenta previa. Methods: This randomized control trial study was conducted on 70 patients with placenta previa diagnosed by ultrasound and Doppler who attended to outpatient clinics and maternity Hospital of Zagazig University Hospital. Women randomly allocated into two groups: Group A: 35 cases of inflated urinary bladders before cesarean section. Group B: 35 cases of non-inflated urinary bladders before cesarean section. All patients were subjected to full detailed history taking, laboratory investigations, full clinical examination including Obstetric ultrasound and Doppler. Results: showed a significantly shorter dissection time, with a mean of 4.6 minutes compared to 5.8 minutes in Group B. Furthermore, hospitalization duration was notably shorter in Group A, with a median of 1 day versus 3 days in Group B. Additionally, urinary catheter retention was significantly reduced in Group A, with 97.1% of patients having the catheter removed within 12 hours, compared to 62.9% in Group B. Conclusion: Women presenting with placenta previa had reduced risk of bladder injuries, shorter dissection time, shorter duration of hospitalization and shorter duration of retention of urinary catheter as a result of cystodistention during cesarean section for placenta previa.