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Female Pelvic Medicine & Reconstructive Surgery:
doi: 10.1097/SPV.0000000000000059
Case Reports

Minimally Invasive Management of Retropubic Bleeding and Hematoma Evacuation After a TVT Secur or Mini-Sling Procedure

O’Boyle, Amy L. MD*; DiCarlo-Meacham, Angela MD; Hernandez, Sandra MD*

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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.

© 2014 by Lippincott Williams & Wilkins


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