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PL.75 An Audit of Lower Urinary Tract Injuries in a Large Obstetric Unit – 2 Year Outcome
  1. BD Upadhyay
  1. St George’s University London, London, UK

Abstract

Objective The main objective of this audit was to investigate the number of bladder injuries after delivery and compare it to the existent incidence in literature.

Method Retrospective medical record review of patients in Kingston Hospital’s Obstetric department who had suffered from either ureteric or bladder injury between January 2011 and November 2012. A record of all these patients was recovered from the Obstetric electronic database.

Results There were a total of 11,246 deliveries between January 2011 and November 2012. Out of these 6,356 were normal vaginal deliveries, 1,684 were instrumental deliveries and 3,206 were caesarean sections. There were 6 cases of bladder injury found, all during caesarean section. 3 out of the 6 cases had caesarean section before the index pregnancy. 3 others had placenta praevia. Of these 3 previous caesarean section patients, 2 were unsuccessful at vaginal birth after caesarean section. One of them had a scar dehiscence extending to the bladder. Subsequent repair in all 6 cases was successful as indicated by normal imaging and a successful trial without catheter following 2 weeks of being catheterised.

Conclusion The rate of bladder injury found was 6/11,246 deliveries between January 2011 and November 2012. The incidence of bladder injury following caesarean delivery, 6/3,206 is comparable to the literature. This study also found that having a previous caesarean delivery increased the likelihood of having a bladder injury after caesarean delivery. Subsequent repair of bladder injury demonstrated good success rates.

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