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Foley balloon to tamponade bleeding in the retropubic space
Matthew Aungst1, Michael Wagner
1Department of Obstetrics and Gynecology, Kaiser Vallejo Medical Center, Vallejo, California, USA. mathew.aungst@60mdg.travis.af.mil
Background:
Hemorrhage from the retropubic space is a well-described complication of the tension-free vaginal tape procedure that can be difficult to control with conservative measures.
Case:
A 40-year-old female patient underwent tension-free vaginal tape procedure to treat stress incontinence. The procedure was complicated by persistent intraoperative bleeding from the retropubic space. The hemorrhage was refractory to digital tamponade but was successfully controlled by tamponade with a Foley catheter. The catheter was inserted with use of the urology guide wire from the vagina along the path of the tunneler into the retropubic space and inflated, successfully controlling the hemorrhage.
Conclusion:
Persistent bleeding during tension-free vaginal tape procedure from the retropubic space can be controlled with a Foley catheter placed from the vagina into the space of Retzius.