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International Urogynecology Journal

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01-03-2016 | Original Article

Management of arterial and venous hemorrhage during sacrospinous ligament fixation: cases and review of the literature

Authors: Avita K. Pahwa, Lily A. Arya, Uduak U. Andy

Published in: International Urogynecology Journal | Issue 3/2016

Abstract

Introduction and hypothesis

Sacrospinous ligament fixation (SSLF) for pelvic organ prolapse repair can incur significant intraoperative hemorrhage. Management of vascular injury is challenging because of limited visualization of the surrounding pararectal space and is not well described in the literature.

Methods

We evaluate cases of intraoperative venous and arterial hemorrhage during SSLF. Based on a review of the literature, we present a systematic approach to the treatment of venous and arterial hemorrhage associated with SSLF.

Results

Vascular injury to the hypogastric and pudendal venous plexi may be controlled using directed compression and topical hemostatic agents. Vascular injury to the inferior gluteal artery, its coccygeal branch, or other arteries, may require embolization.

Conclusion

Life-threatening bleeding is a rare complication of transvaginal SSLF. Knowledge of surrounding pelvic vascular anatomy, treatment options, and communication with ancillary staff is essential for the treatment of sacrospinous ligament hemorrhage.

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Title: Management of arterial and venous hemorrhage during sacrospinous ligament fixation: cases and review of the literature
Authors: Avita K. Pahwa
Lily A. Arya
Uduak U. Andy
Publication date: 01-03-2016
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 3/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2818-2

At a glance: The STEP trials

Springer Medicine

Management of arterial and venous hemorrhage during sacrospinous ligament fixation: cases and review of the literature

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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