Aim Of The Video: Sacrospinous ligament fixation (SSLF) is a minimally invasive transvaginal procedure for correcting apical prolapse. Amongst perioperative complications, life-threatening hemorrhage has a reported occurrence rate ranging from 0.2 % to 2 %. We present a case of arterial hemorrhage following SSLF and a multispecialty approach to its successful management.
Methods: The video demonstrates the development of an unexpected progressive postoperative hematoma following left-side sacrospinous hysterocolpopexy via the anterior approach, despite minimal intraoperative bleeding. The mechanism of formation of the hematoma could have been laceration of an aberrant vaginal branch of the inferior vesical artery secondary to pulling the anchor which is tied off at the cervix after closure. To treat these patients effectively, it is essential for the surgeon to make a timely diagnosis, and in our patient, embolization of the inferior vesical artery provided a safe and effective treatment for the pelvic hemorrhage that eliminated the need for an invasive surgical intervention.
Conclusion: Life-threatening bleeding is a rare complication of transvaginal SSLF. Pelvic vessel embolization can provide an effective, minimally invasive alternative to surgical re-exploration.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00192-016-3121-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Laparoscopic Pudendal Nerve Release at the Level of Sacrospinous Ligament.
Int Urogynecol J
January 2025
Vitale Private Obstetrics & Gynecology Hospital, Antalya, Türkiye.
Introduction And Hypothesis: Pudendal nerve release can be managed by the laparoscopic approach for pudendal nerve entrapment.
Methods: This is a case report of a stepwise demonstration of the technique with narrated video footage. A 71-year-old woman, gravid 7, parity 3, abortion 4, live births 3 vaginal delivery, complained of pain while sitting.
Letter to the Editor: The Outcomes of the Manchester Procedure Versus Sacrospinous Ligament Hysteropexy for Uterine Prolapse: A Study of the British Society of Urogynaecology Database.
Int Urogynecol J
November 2024
Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Subtotal vaginal hysterectomy with cervical ring preservation and cervical stump suspension to the sacrospinous ligament in women with pelvic organ prolapse: An exposed cohort study.
Rev Colomb Obstet Ginecol
October 2024
Ginecología y Obstetricia, Universidad Libre, Clínica La Merced. Barranquilla (Colombia).
Objectives: To evaluate the short-term safety and efficacy of vaginal hysterectomy with cervical preservation in patients with genital prolapse stages II to IV.
Materials And Methods: This is a descriptive case series study. It included women with genital prolapse stages II to IV, indicated for vaginal hysterectomy, with negative cervicovaginal cytology for malignancy, who underwent subtotal vaginal hysterectomy with suspension of the cervical stump to the sacrospinous ligament between June 1 and December 31, 2023, at a high-complexity general clinic.
Comparison of the complications rate of different suture-passing techniques at the time of sacrospinous ligament fixation: a systematic review and meta-analysis.
Arch Gynecol Obstet
December 2024
Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Objective: This study was designed to assess the complications raised in different suture-passing techniques when fixating the Sacrospinous ligament for pelvic organ prolapse (POP).
Search Strategy: We searched PubMed, Embase, Scopus, Web of Sciences, ProQuest, Google Scholar, and Cochrane Library, and performed a systematic review meta-analysis to assess complications when implementing different suture passings in fixating the sacrospinous ligament.
Selection Criteria: The inclusion and exclusion criteria for literature screening were predetermined to allow for a more rigorous process.
Sacrospinous Hysteropexy-Video Tutorial of Construction and Application of a Feasible and Inexpensive Teaching Model for Simulation.
Int Urogynecol J
November 2024
Department of Obstetrics and Gynaecology, University Hospital of Zurich, Zurich, Switzerland.
Introduction And Hypothesis: Sacrospinous hysteropexy is one of the preeminent uterus-preserving surgical techniques for treating pelvic organ prolapse supported by level one evidence. As training on models greatly improves surgical skills and outcomes, we developed a simple and inexpensive model to simulate sacrospinous hysteropexy.
Methods: A step-by-step instruction for the production of the model is available to be viewed online.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!