Injury of the corona mortis during vaginal tape insertion (TVT-Secur™ using the U-Approach).
OBJECTIVE
We report a serious bleeding complication due to injury of the corona mortis following insertion of a transvaginal tape, TVT-Secur™ (Ethicon Women's Health, Sommerville, NJ, USA).


METHODS
The TVT-Secur™ was inserted using the U-Approach: the tape was pushed along the periost behind the arc of the pubic bone at an angle of 45°.


RESULTS
Surgery was unproblematic. Four hours after surgery, the patient showed shock signs; a CT scan revealed a 13.5 × 9.5-cm-sized retrosymphysic haematoma. Instant laparotomy with removal of the large haematoma, ligation of the bleeding corona mortis and administration of erythrocyte concentrates were necessary.


CONCLUSIONS
The corona mortis is an anastomosis between the arteria obturatoria and the external iliac vessels or its branches that passes over the superior pubic ramus. Its prevalence and anatomical relation to the pubic bone are important to bear in mind when applying new surgical techniques.
Bürgerspital Solothurn, 4500 Solothurn, Switzerland. ursula_gobrecht@hotmail.com
Ursula
U
Gobrecht
Annette
A
Kuhn
Bernhard
B
Fellman
D000368:Aged; D001163:Arteriovenous Anastomosis / Q000293:injuries*; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
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