Analisis Faktor Risiko Cedera Buli Iatrogenik pada Operasi Obstetri

Abstract

Background: Bladder is one of urinary tract that is anatomically close to gynecological organs. The risk of iatrogenic bladder injuries is an undesirable event. It can increase in obstetric and gynecological  procedures. We can identified  the risk factors for iatrogenic bladder injuries can be identified at the beginning of operations. One of which is related to distorted pelvic anatomy, including adhesions, history of surgery, endometriosis and obesity. The type of surgery also plays a role in increasing risk of iatrogenic bladder injuries. This study aims to determine the risk factors that can increase iatrogenic bladder injuries in obstetric and gynecological surgery at Dr. RSUP. Sardjito in 2015-2020.Objective: To determine the risk factors that increase iatrogenic bladder injury in obstetric and gynecological surgery at dr. Sardjito in 2015-2020Method: Case control study was conducted at Dr. RSUP. Sardjito, Yogyakarta from January 2021 to March 2022. There were 120 patient subjects who underwent obstetric and gynecological procedures at Dr. Sardjito Hospital from 2015 to 2020 who entered the inclusion criteria. The relationship between risk factors and the incidence of iatrogenic bladder injuries was analyzed using the Chi Square test. Multivariate analysis to determine the most important risk factors were analyzed using Logistic Regression test. Data analysis with SPPS version 22.0Results and Discussion: In this study, there was an association between adhesions and the incidence of iatrogenic bladder injuries (OR = 28,895 (95% CI 9111 – 91,641); p < 0.001). However, there was no association between endometriosis, type of surgery, previous surgery, body mass index, age, parity, amount of bleeding, timing of surgery and malignancy with the incidence of iatrogenic bladder injuries (p > 0.05).Conclusion : Adhesions had 29 times risk for increasing iatrogenic bladder injuries in this study.Keywords: Adhesions, Distorted Pelvic Anatomy, Risk Factors, Iatrogenic Bladder Injuries, Obstetrics, Gynaecology