[Arterial injury associated with tension-free vaginal tape procedure successfully treated by radiological embolization: a case report].
A 75-year-old woman underwent a tension-free vaginal tape (TVT) procedure for urinary stress incontinence. The patient complained of lower abdominal pain, a feeling of lower abdominal distension and nausea three hours after the operation. In addition, systolic blood pressure decreased gradually to 80 mmHg. Enhanced computed tomography revealed a retropubic hematoma sized up to 16 cm X 12 cm X 11 cm and bleeding from a vessel running through the posterosuperior aspect of the pubic bone. Successively, arteriography was performed. The arteriogram also confirmed arterial injury, which was successfully treated by selective embolization using a gelatin sponge and pushable coils. Postoperative course was uneventful requiring neither blood transfusion nor surgical removal of the hematoma.
Takatera
Hiroshi
H
The Department of Urology, Yao Tokusyukai General Hospital.
Mukai
Masatoshi
M
Fujii
Takahiro
T
Nishi
Masayo
M
Okada
Hiroshi
H
Nishimine
Kiyoshi
K
Tsushima
Juichi
J
D000368:Aged; D001158:Arteries / Q000293:injuries*; D004621:Embolization, Therapeutic; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006406:Hematoma / Q000209:etiology / Q000628:therapy*; D006801:Humans; D011183:Postoperative Complications / Q000628:therapy*; D019736:Prostheses and Implants; D011630:Pubic Bone / Q000098:blood supply*; D013526:Surgical Mesh; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects; D014621:Vagina / Q000601:surgery