Visceral Injury During CS

Urinary tract and bowel injury at the time of Cesarean section.
Module by: Margaret Burnett.

Learning objectives

  • Minimize urinary and gastrointestinal tract injury during cesarean section
  • Recognize unintended visceral injury intraoperatively
  • Use best practice in repairing bladder and gastrointestinal lacerations
  • Manage postoperative care following visceral injury


Injury to the urinary or gastrointestinal tract is rare in the course of cesarean section.  The most common is laceration of the bladder with an incidence of 2 in 1000 cesarean sections.  Less common are injuries to the colon with the least common being ureteric injury.  In all cases, a history of previous surgery, usually prior cesarean section, is the most significant risk factor. However, any condition that predisposes to adhesion formation may be a factor.

  • Bladder injury is most common 2/1000
  • Bowel 1/1000
  • Ureter 0.3/1000
  • Previous surgery is the most important risk factor
  • Other risk factors include abnormal placentation, obstructed labour, pelvic adhesions (due to previous surgery, pelvic inflammatory disease, endometriosis, etc.)


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Updated on February 16, 2022

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