Justifying formation of bladder flap at cesarean section?
BACKGROUND
Creation of the bladder flap, i.e., dissecting the urinary bladder from the lower segment of the uterus is a standard part of cesarean section (CS). However, it is yet to be established whether the formation of bladder flap is advantageous.


METHODS
Pelosi and Ortega in 1994 introduced a new minimally invasive technique of CS, which included the omission of bladder dissection together with other modifications. Omission of the bladder flap provides short-term benefits such as reduction of operating time and incision-delivery interval, wound infection, reduced blood loss and analgesic requirement. In addition, it is associated with good long-term outcomes with regards to adhesion formation.


CONCLUSIONS
Further large-scale controlled randomized clinical trials are needed to investigate the safety of this technique with respect to in deeply engaged head, preterm, subsequent pregnancies and trial of labor and also to determine the future role of this technique that will contribute to advancement and popularity of this technique amongst obstetricians.
Mahajan
Niraj N
NN
Department of Obstetrics and Gynaecology, Padhar Hospital, Padhar, Betul, MP, India. nirajdr@hotmail.com
D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011247:Pregnancy; D001743:Urinary Bladder / Q000601:surgery*