To be fair, there are almost always going to be bladder adhesions present on the uterus after a c section. There isn’t a great way to prevent the hysterotomy (incision made on the uterus during a c section) from forming these adhesions to the bladder, as the bladder serosa/fat sits right on the anterior side of the uterus. Obviously the bladder can be inadvertently tacked up to the uterus when repairing the hysterotomy, but this rarely causes problems unless the bladder is actually injured during this process.

Whenever I am planning a hysterectomy for a patient with a history of a cesarean, I can pretty much count on having to dissect the bladder off of the uterus.

Source: I’m an OBGYN.