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International Urogynecology Journal
Published in: International Urogynecology Journal 4/2011

01-04-2011 | Case Report

Injury of the corona mortis during vaginal tape insertion (TVT-Secur™ using the U-Approach)

Authors: Ursula Gobrecht, Annette Kuhn, Bernhard Fellman

Published in: International Urogynecology Journal | Issue 4/2011

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Abstract

Introduction and hypothesis

We report a serious bleeding complication due to injury of the corona mortis following insertion of a transvaginal tape, TVT-Secur™ (Ethicon Women's Health, Sommerville, NJ, USA).

Methods

The TVT-Secur™ was inserted using the U-Approach: the tape was pushed along the periost behind the arc of the pubic bone at an angle of 45°.

Results

Surgery was unproblematic. Four hours after surgery, the patient showed shock signs; a CT scan revealed a 13.5 × 9.5-cm-sized retrosymphysic haematoma. Instant laparotomy with removal of the large haematoma, ligation of the bleeding corona mortis and administration of erythrocyte concentrates were necessary.

Conclusion

The corona mortis is an anastomosis between the arteria obturatoria and the external iliac vessels or its branches that passes over the superior pubic ramus. Its prevalence and anatomical relation to the pubic bone are important to bear in mind when applying new surgical techniques.
Literature
1.
Larsson PG, Teleman P, Persson J (2010) A serious bleeding complication with injury of the corona mortis with the TVT-Secur procedure. Int Urogynecol J Pelvic Floor Dysfunct 21:1175–1177PubMedCrossRef
2.
Rusu MC, Cergan R, Motoc AG, Folescu R, Pop E (2010) Anatomical considerations on the corona mortis. Surg Radiol Anat 32:17–24PubMedCrossRef
3.
Hubka P, Svabik K, Martan A, Masata J (2010) A serious bleeding complication with injury of the corona mortis with the TVT-Secur procedure: two cases of contact of TVT-S with the corona mortis during cadaver study. Int Urogynecol J Pelvic Floor Dysfunct 21:1179–1180PubMedCrossRef
4.
Martan A, Svabik K, Masata J, Koleska T, El-Haddad R, Pavlikova M (2009) Correlation between changes in ultrasound measurements and clinical curative effect of tension-free vaginal tape-SECUR* procedure. Int Urogynecol J Pelvic Floor Dysfunct (in press)
Metadata
Title
Injury of the corona mortis during vaginal tape insertion (TVT-Secur™ using the U-Approach)
Authors
Ursula Gobrecht
Annette Kuhn
Bernhard Fellman
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 4/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1355-2

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