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RESIDENT’S CORNER

Pelvic hematoma following transobturator tape procedure: case report and review of literature

Jason W. Anast, Elizabeth R. Williams, Carl Klutke

Division of Urology, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
Address correspondence to Dr. Carl Klutke, 1040 North Mason Road, Suite 122, St. Louis Missouri USA 63141

Canadian Journal of Urology 2008, 15(1), 3930-3932.

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.
Material and 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 × 10 cm × 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.

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