Ultrasound-Guided and Laparoscopic Instrument-Assisted Drainage of Retropubic Hematoma Secondary to Laparoscopic Burch Colposuspension

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Abstract

A 37-year-old, gravida 3, para 3 woman presented with intermittent fever, chills, and vague lower abdominal pain for 2 days. Ten days previously, she had undergone a transperitoneal laparoscopic Burch colposuspension for stress urinary incontinence. Physical examination and ultrasonography showed a tender mass, about 7 x 6 cm in size, occupying the retropubic space. Her hematogram disclosed a hemoglobin of 9 g/dL and a white cell count of 18,000/μL with 80% neutrophils. Analgesics and parenteral broad-spectrum antimicrobial agents were given after admission, but were in vain. We proceeded to drain the infected hematoma by using a high-flow suction-irrigation probe through a 5-mm trocar under ultrasound guidance. With strong hydraulic pressure, the probe enabled aquadissection with disruption and complete evacuation of blood clots. The woman experienced a prompt recovery from the complication.

Original languageEnglish
Pages (from-to)161-165
Number of pages5
JournalJournal of Gynecologic Surgery
Volume19
Issue number4
Publication statusPublished - Dec 2003
Externally publishedYes

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Hematoma
Drainage
Chills
Stress Urinary Incontinence
Suction
Anti-Infective Agents
Surgical Instruments
Abdominal Pain
Physical Examination
Analgesics
Ultrasonography
Hemoglobins
Neutrophils
Thrombosis
Fever
Cell Count
Pressure

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

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title = "Ultrasound-Guided and Laparoscopic Instrument-Assisted Drainage of Retropubic Hematoma Secondary to Laparoscopic Burch Colposuspension",
abstract = "A 37-year-old, gravida 3, para 3 woman presented with intermittent fever, chills, and vague lower abdominal pain for 2 days. Ten days previously, she had undergone a transperitoneal laparoscopic Burch colposuspension for stress urinary incontinence. Physical examination and ultrasonography showed a tender mass, about 7 x 6 cm in size, occupying the retropubic space. Her hematogram disclosed a hemoglobin of 9 g/dL and a white cell count of 18,000/μL with 80{\%} neutrophils. Analgesics and parenteral broad-spectrum antimicrobial agents were given after admission, but were in vain. We proceeded to drain the infected hematoma by using a high-flow suction-irrigation probe through a 5-mm trocar under ultrasound guidance. With strong hydraulic pressure, the probe enabled aquadissection with disruption and complete evacuation of blood clots. The woman experienced a prompt recovery from the complication.",
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N2 - A 37-year-old, gravida 3, para 3 woman presented with intermittent fever, chills, and vague lower abdominal pain for 2 days. Ten days previously, she had undergone a transperitoneal laparoscopic Burch colposuspension for stress urinary incontinence. Physical examination and ultrasonography showed a tender mass, about 7 x 6 cm in size, occupying the retropubic space. Her hematogram disclosed a hemoglobin of 9 g/dL and a white cell count of 18,000/μL with 80% neutrophils. Analgesics and parenteral broad-spectrum antimicrobial agents were given after admission, but were in vain. We proceeded to drain the infected hematoma by using a high-flow suction-irrigation probe through a 5-mm trocar under ultrasound guidance. With strong hydraulic pressure, the probe enabled aquadissection with disruption and complete evacuation of blood clots. The woman experienced a prompt recovery from the complication.

AB - A 37-year-old, gravida 3, para 3 woman presented with intermittent fever, chills, and vague lower abdominal pain for 2 days. Ten days previously, she had undergone a transperitoneal laparoscopic Burch colposuspension for stress urinary incontinence. Physical examination and ultrasonography showed a tender mass, about 7 x 6 cm in size, occupying the retropubic space. Her hematogram disclosed a hemoglobin of 9 g/dL and a white cell count of 18,000/μL with 80% neutrophils. Analgesics and parenteral broad-spectrum antimicrobial agents were given after admission, but were in vain. We proceeded to drain the infected hematoma by using a high-flow suction-irrigation probe through a 5-mm trocar under ultrasound guidance. With strong hydraulic pressure, the probe enabled aquadissection with disruption and complete evacuation of blood clots. The woman experienced a prompt recovery from the complication.

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