Embolization in Patient with Hypovolemic Shock after Transobturator Sling Procedure

Abstract

The placement of a suburethral sling is standard treatment for stress urinary incontinence. The transobturator technique (TOT) emerged as an alternative to minimize the risks of the blind insertion of needles, leading to a lower rate of perforation complications compared with the retropubic approach. We present a case of injury to a branch of the left obturator artery following the placement of a urethral sling using TOT, followed by intense bleeding and hemodynamic instability, which was treated with embolization.

Resumo

Sling de uretra média é o tratamento padrão para a incontinência urinária de esforço. A abordagem transobturatória (TOT) surgiu como alternativa para minimizar os riscos da inserção às cegas das agulhas com taxa de complicações perfurativas menores quando comparadas à abordagem retropúbica. Apresentamos um caso de lesão em ramo da artéria obturatória esquerda após sling TOT que evoluiu com sangramento intenso e instabilidade hemodinâmica, sendo tratado com embolização.

Keywords

hemorrhagic shock - embolization - postoperative complications - suburethral sling - urinary incontinence

Palavras-chave

choque hemorrágico - embolização - complicações pós-operatórias - sling - incontinência urinária

Publikationsverlauf

Eingereicht: 18. Mai 2020

Angenommen: 03. August 2020

Artikel online veröffentlicht:
30. November 2020

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