Papp Sara B, Gaitonde Shivani, Baig Shadman, Zimmern Philippe E
University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
Case Rep Womens Health. 2023 Aug 8;39:e00533. doi: 10.1016/j.crwh.2023.e00533. eCollection 2023 Sep.
Vaginal mesh exposures and infections are recognized complications of open and laparoscopic sacrocolpopexy performed for vault prolapse. In severe cases, complete sacrocolpopexy mesh removal may be necessary. This case report presents a 72-year-old woman with previous mesh sacrocolpopexy who presented with infected mesh and recurrent vaginal bleeding despite multiple attempts at surgical transvaginal mesh excision. A life-threatening massive hemorrhage occurred intra-operatively. After several failed attempts to control bleeding, hemorrhage Occluder™ Pins were successfully placed by vascular surgery to control presacral veins. Although an exceedingly rare complication, anticipation and rapid management of life-threatening bleeding are critical to save life during complicated mesh removals.
阴道网片暴露和感染是因穹窿脱垂而行开放性和腹腔镜骶骨阴道固定术公认的并发症。在严重情况下，可能需要完全切除骶骨阴道固定术的网片。本病例报告介绍了一名72岁女性，既往接受过网片骶骨阴道固定术，尽管多次尝试经阴道手术切除网片，但仍出现网片感染和反复阴道出血。术中发生了危及生命的大出血。在多次控制出血尝试失败后，血管外科成功置入Hemorrhage Occluder™ 针以控制骶前静脉出血。尽管这是一种极其罕见的并发症，但在复杂的网片切除术中，对危及生命的出血进行预判并迅速处理对于挽救生命至关重要。
