title: Minimally invasive management of retropubic bleeding and hematoma evacuation after a TVT Secur or mini-sling procedure.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: From the *Walter Reed National Military Medical Center, Bethesda, MD; and †Naval Hospital Okinawa, Okinawa, Japan.
authors.forename: Amy L
authors.initials: AL
authors.lastname: O'Boyle
authors.forename: Angela
authors.initials: A
authors.lastname: DiCarlo-Meacham
authors.forename: Sandra
authors.initials: S
authors.lastname: Hernandez
mesh_terms: D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006406:Hematoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery*; D053825:Suburethral Slings / Q000009:adverse effects; D053832:Surgical Tape / Q000009:adverse effects; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery