Clinical center of Memmingen, Department of Obstetrics and Gynecology, Germany.
Eur J Obstet Gynecol Reprod Biol. 2011 Sep;158(1):101-3. doi: 10.1016/j.ejogrb.2011.04.012. Epub 2011 May 23.
Retropubic hematomas are rare but typical complications during or after the tension-free vaginal tape (TVT) procedure. We investigated the possibility of treating these hematomas with retziusscopy, as an update of a previous study by our group.
Over a 10-year period the clinical course of all 685 consecutive patients undergoing the tension-free vaginal tape procedure (TVT, Gynecare) was prospectively recorded, including management strategies for clinically relevant hematomas. We report on 10 patients with hematoma and our following surgical management.
In twenty-eight patients (4.1%) a symptomatic retropubic hematoma developed. In 10 cases (1.5%) volume exceeded 250 mL (range 250-1000 mL). These patients required surgical intervention because of moderate or severe symptoms. In the first case we performed open laparotomy, whereas in the following cases the hematomas could be successfully drained by retziusscopy.
In cases of large masses, intervention may be necessary because of significant discomfort. This can usually be achieved by a minimally invasive retziusscopy.
耻骨后血肿是阴道无张力吊带（TVT）手术过程中或之后罕见但典型的并发症。我们研究了使用直肠镜治疗这些血肿的可能性，这是我们小组之前的一项研究的更新。
在 10 年期间，前瞻性地记录了 685 例连续接受阴道无张力吊带（TVT，Gynecare）手术的患者的临床过程，包括对临床相关血肿的管理策略。我们报告了 10 例血肿患者及其随后的手术治疗情况。
在 28 例患者（4.1%）中出现了症状性耻骨后血肿。在 10 例患者（1.5%）中，血肿体积超过 250 mL（范围 250-1000 mL）。由于中度或重度症状，这些患者需要手术干预。在首例患者中，我们进行了剖腹手术，而在随后的病例中，血肿可以通过直肠镜成功引流。
对于大肿块，由于明显的不适，可能需要介入治疗。这通常可以通过微创的直肠镜来实现。
