Bleeding complications with the tension-free vaginal tape operation.
OBJECTIVE
This study was undertaken to analyze bleeding problems with tension-free vaginal tape (TVT) operations in a national registry.


METHODS
We studied patients for whom increased intraoperative bleeding or reoperation for bleeding/hematoma with TVT operation were reported to the registry.


RESULTS
Bleeding problems were reported for 151 of 5578 (2.7%) TVT operations. Increased intraoperative bleeding was reported for 106 (1.9%) and reoperation (or conversion) in 45 (0.8%) patients (both in 5 patients). Increased intraoperative bleeding was managed conservatively in 103 patients (95%). Overall, 45 (0.8%) patients required reintervention for bleeding or hematoma. The reinterventions comprised 34 laparotomies, 4 transvaginal evacuations of hematomas, 3 revisions for bleeding from a suprapubic catheter site, and 2 revisions of the vaginal incision (details unclear in 1 patient). Bleeding was considered arterial in 12% (including 1 external iliac artery injury and 1 obturator artery injury) and venous or unknown in 88%. Of reoperated patients, 39% were reoperated within 24 hours, 20% within 2 to 10 days, and 41% within 11 to 56 days after TVT placement. Overall, 19 patients received blood transfusions (range, 1-10 units). There were no deaths from bleeding complications.


CONCLUSIONS
Bleeding complications were reported with less than 3% of 5578 TVT operations. Most cases of increased intraoperative bleeding were managed conservatively; 0.8% of patients required conversion or reoperation.
Kölle
Dieter
D
Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
Tamussino
Karl
K
Hanzal
Engelbert
E
Tammaa
Ayman
A
Preyer
Oliver
O
Bader
Arnim
A
Enzelsberger
Hermann
H
Ralph
George
G
Riss
Paul
P
D001317:Austria / Q000453:epidemiology; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D005260:Female; D006406:Hematoma / Q000453:epidemiology*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D019736:Prostheses and Implants; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*