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A life-threatening hematoma after the single-incision sling MiniArc procedure: a case report
1Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Changhua Christian Hospital and General Education Center, Chienkuo Technology University, Changhua, Taiwan. 13212@cch.org.tw
Abstract:
The newer generation of single-incision slings such as the MiniArc may minimize these risks by avoiding the passage of needles through the obturator foramen and muscles. However, they may still lead to severe vascular injuries. We report a case of a life-threatening obturator hematoma forming after a MiniArc procedure. We determined the exact location using a computed tomographic scan of the pelvis, and it was surgically managed. The patient's symptoms subsided, and her vital signs stabilized after the hematoma was removed using a transvaginal approach. Single-incision slings may be associated with life-threatening vascular complications.
Insights
Single-incision slings, like MiniArc, can cause severe vascular injuries. A rare case highlights the risk of life-threatening obturator hematoma after this procedure.
Area of Science:
- Urology
- Gynecology
- Surgical Innovation
Background:
- Single-incision slings are designed to reduce surgical risks associated with traditional mid-urethral slings.
- The MiniArc system aims to minimize complications by altering needle trajectory during placement.
Observation:
- A patient developed a life-threatening obturator hematoma following a MiniArc single-incision sling procedure.
- The hematoma's location was precisely identified using computed tomographic (CT) imaging of the pelvis.
Findings:
- Surgical management, specifically a transvaginal approach for hematoma removal, led to symptom resolution.
- The patient's vital signs stabilized post-operatively, indicating successful treatment.
Implications:
- Despite design modifications, single-incision slings carry a risk of severe and potentially life-threatening vascular complications.
- Vigilance for vascular injury is crucial even with newer surgical techniques for stress urinary incontinence.