title: Pelvic hematoma following transobturator tape procedure: case report and review of literature.
abstract: OBJECTIVE
  The transobturator tape (TOS) procedure is rapidly becoming a preferred treatment for female stress urinary incontinence due to excellent outcomes and minimal morbidity. Though rare, significant bleeding complications can occur.
  
  
  METHODS
  We review our experience and available literature of pelvic hematoma formation after TOS placement.
  
  
  RESULTS
  A 56-year-old woman underwent a TOS procedure for stress incontinence. She returned on postoperative day three with nausea and vague suprapubic discomfort, though voiding without difficulty. Office ultrasound and computed tomographic imaging revealed a bi-lobed 8 cm x 10 cm x 11 cm hematoma in the Space of Retzius. She was treated conservatively with intravenous pain medication and antiemetics and without blood transfusion. Four weeks after the procedure, the patient had no voiding, pain, or bowel complaints. Literature review yielded two other reports of five patients with similar presentations who were successfully treated conservatively.
  
  
  CONCLUSIONS
  Pelvic hematoma formation after the TOS procedure is a rare event and can usually be managed conservatively.
authors.affiliation: Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63141, USA.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Anast
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Williams
authors.forename: Carl
authors.initials: C
authors.lastname: Klutke
mesh_terms: D005260:Female; D006406:Hematoma / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D010388:Pelvis; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery