Urgent Evaluation of Bladder Injury during Cesarean Section: Risks and Management
Bright red bloody urine in the catheter draining the bladder alerts a surgeon to consider immediately an injury to the bladder. If this is noticed at the time of a cesarean section, the surgeon must evaluate the bladder. The bladder can be assessed by careful inspection of the bladder at and around the surgical site. The bladder, through the catheter in the bladder, can be filled with different types of fluids to be sure there has not been a hole made in it. In addition, a cystoscopy can be performed to look into the bladder. If a bladder injury is noted at the time of surgery, it must be appropriately addressed at that time. Delay in repair can lead to patient morbidity inclusive of, but not limited to, pelvic scarring from urine leaking into the pelvis, pelvic infection, increased post-operative pain, and the risks of a return to the operating room including those associated with another course of anesthesia. Scaring can result in long-term bladder pain and voiding dysfunction.
Blood in urinary catheter medical expert witness specialties include urology, emergency nursing, critical care, surgical critical care, and hospitalist medicine.