Journal of Volgograd State Medical UniversityJournal of Volgograd State Medical University1994-94801994-9499Volgograd State Medical University34090710.19163/1994-9480-2023-20-1-129-131Research ArticlePrevention of bladder damage during repeated caesarean sectionsOmarovNabi S.-M.<p>Doctor of Medical Sciences, Professor, Head of the Department of Obstetrics and Gynecology</p>sitoru@gmail.comDabuzovAbakar S.<p>Candidate of Medical Sciences, Assistant of the Department of Obstetrics and Gynecology</p>dabakar1952@mail.ruDagestan State Medical University230420232011291312204202322042023Copyright © 2023, Omarov N.S., Dabuzov A.S.2023<p>Repeated cesarean section operations are becoming a daily practice in obstetric institutions of the 2nd and 3rd groups. With each subsequent operation, due to adhesions or infectious complications (obstetric peritonitis), the risks of injuries to organs adjacent to the uterus increase. <strong>Objective</strong>: development of a method for preventing to the bladder injury during repeated cesarean section operations. <strong>Materials and methods</strong>: Prospective cohort studies were performed in 320 patients with the scar after Caesarean Section who underwent a repeated cesarean section: 186 patients were operated in plan and 134 in urgent situation. All patients had given the hydropreparation of paravesical tissue by 0.5 % solution of novocaine 20 ml, which was injected under the vesicouterine fold from the side of the round ligaments for the prevention injury of bladder. Statistical processing was carried out using the Statistica 13 package. <strong>Results and discussion</strong>: With partial mobilization of the posterior wall, bladder injury in group 1 was in 2 patients, in group 2 in 4 patients (<sup>2</sup> = 1.544, <em>p</em> = 0.215). The injury of the bladder walls in group 2 occurred in patients operated on for obstetric peritonitis and was caused by pronounced infiltration of paravisical tissue and inflammatory changes in the lower segment of the uterus. <strong>Conclusions</strong>: The developed method by hydropreparation the paravesical tissue allows minimizing the number of bladder injuries with a pronounced adhesive process in the lower segment of the uterus or tissue infiltration with purulent-inflammatory complications.</p>repeated cesarean sectionbladder injuryhydropreparation of paravesical tissueповторное кесарево сечениеранение стенки мочевого пузырягидропрепаровка паравезикальной клетчатки[Zharkin N.A., Logutova L.S., Semihova T.G. Caesarean section: medical, social and moral-ethical problems. Rossijskij vestnik akushera-ginekologa = Russian Bulletin of Obstetrician-Gynecologist. 2019;19(4):5–10. doi.org/10.17116/rosakush2019190415. (In Russ.).][Yametova N.M., Ckhaj V.B., Domracheva M.Y. Repeated cesarean section in women with two or more scars on the uterus. Medicinskij vestnik Yuga Rossii = Medical Bulletin of the South of Russia. 2021;12(3):86–91. doi: 10.21886/2219-8075-2021-12-3-86-91. (In Russ.).][Safrai M., Stern S., Gofrit N. et al. Urinary tract injuries during cesarean delivery: long-term outcome and management. J Matern Fetal Neonatal Med. 2022;35(18):3547–54. doi: 10.1080/14767058.2020.1828336.][Chill H. H., Karavani G., Reuveni-Salzman A. et al. Urinary bladder injury during cesarean delivery: risk factors and the role of retrograde bladder filling. Int Urogynecol J. 2021;32(7):1801-1806. doi: 10.1007/s00192-020-04630-9.][Salman L, Aharony S., Shmueli A. et al. Urinary bladder injury during cesarean delivery: Maternal outcome from a contemporary large case series. Eur J Obstet Gynecol Reprod Biol. 2017;213:26–30. doi: 10.1016/j.ejogrb.2017.04.007.]