BACKGROUND: Retropubic hematomas may complicate up to 4.1% of tension-free vaginal tape (TVT) procedures in the surgical treatment of stress urinary incontinence.
Symptomatic or expanding hematomas often require intervention, usually accomplished through an abdominal incision.
CASE: A 43-year-old woman underwent transvaginal management of venous bleeding and evacuation of a 1500-mL retropubic hematoma after a TVT Secur or "mini-sling" procedure.
CONCLUSIONS: Significant bleeding can complicate even the least invasive surgical approach to treat stress urinary incontinence. Transvaginal evacuation of a symptomatic retropubic hematoma with instillation of a hemostatic agent may be a safe alternative to laparotomy in a hemodynamically stable patient.
Written by:
O'Boyle AL, Dicarlo-Meacham A, Hernandez S. Are you the author?
Walter Reed National Military Medical Center, Bethesda, MD; and Naval Hospital Okinawa, Okinawa, Japan.
Reference: Female Pelvic Med Reconstr Surg. 2014 Mar-Apr;20(2):119-20.
doi: 10.1097/SPV.0000000000000059
PubMed Abstract
PMID: 24566219
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