Caesarean: bladder injury: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Caesarean: bladder injury

Sample item

During a repeat caesarean section, clear fluid and gas appear in the urinary catheter bag, with haematuria, and a defect is noticed at the dome of the bladder. What is the correct management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Two-layer repair of the bladder with catheter drainage for about 7 to 10 days

Bladder injury is the commonest urological complication of caesarean section, more frequent in repeat procedures and after prolonged labour. A clean dome laceration is repaired in two layers with absorbable suture, and continuous catheter drainage for 7 to 10 days is followed by a cystogram in complex cases. Injuries near the trigone require ureteric assessment.

Option by option

  • A. Two-layer repair of the bladder with catheter drainage for about 7 to 10 days (correct)

    Correct. Two-layer closure and catheter drainage is standard for a dome injury.

  • B. Leave the defect unrepaired and remove the catheter

    Leaving a defect risks urinary ascites and a fistula.

  • C. Resect the bladder dome with a bowel patch

    Bowel patches are far beyond what a simple dome laceration needs.

  • D. Place a suprapubic catheter and no repair

    A suprapubic catheter alone does not close the defect.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Two-layer repair of the bladder with catheter drainage for about 7 to 10 days. Bladder injury is the commonest urological complication of caesarean section, more frequent in repeat procedures and after prolonged labour.

Why is "Leave the defect unrepaired and remove the catheter" not the answer?

Leaving a defect risks urinary ascites and a fistula.

Why is "Resect the bladder dome with a bowel patch" not the answer?

Bowel patches are far beyond what a simple dome laceration needs.

Why is "Place a suprapubic catheter and no repair" not the answer?

A suprapubic catheter alone does not close the defect.

What concept does this question test?

It tests Caesarean: bladder injury in OBG. A clean dome laceration is repaired in two layers with absorbable suture, and continuous catheter drainage for 7 to 10 days is followed by a cystogram in complex cases. Injuries near the trigone require ureteric assessment.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Caesarean: bladder injury?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.