Background: Urinary tract injuries during cesarean sections are one of the most common complications. Bladder injuries are more frequent than ureteric injuries, with a reported prevalence of 0.5% to 1.5%. Of all the uretric injuries, only one third are discovered during cesarean sections, and the majority of urinary tract injuries are discovered during surgery.

Aim: To determine the prevalence of urinary tract injuries during cesarean section and identify the risk factors causing these complications, their management and their outcomes.

Methods: This retrospective cohort study was conducted on 73 patients underwent cesarean section complicated with urological injuries in Zagazig university hospitals in the last five years. We reviewed all medical records of deliveries from Obstetrics and Gynecology department faculty of medicine, Zagazig university hospital, Egypt between January 2017 and December 2021.

Results: The Incidence of urological injuries during CS was 0.3%. Forty five (61.6%) patients had only surgical history of previous CS and 20 (27.4%) patients had other surgical history rather than CS (appendectomy, cholecystectomy or hernia repair). There were 12 (16.4%) patients had grade 3 of bladder injuries, 54 (74%) patients had grade 4 of bladder injuries and 7 (9.6%) patients had grade 5 of bladder injuries.

Conclusion: The Despite the significant increase in the prevalence of CS, the incidence of urologic injury at the surgery (0.3%) was comparable to earlier literature studies. Our research indicates that patients with a history of CS have an increased risk of bladder injury.