Background & aim: Anterior colporrhaphy with native tissue repair is a common gynecological surgery to correct anterior vaginal wall prolapse. Here, we introduce a rare case of retroperitoneal hematoma after vaginal cystocele repair.
Case report: A 33-year-old woman with abdominal pain and pelvic pressure referred to the Gynecology Emergency Unit of our hospital in Mashhad, Iran. She underwent vaginal cystocele repair on previous day in another hospital. Vaginal examination showed tenderness and bulging with a large ecchymotic area around labia majora that extended to buttock. On admission to our hospital, her vital signs showed tachycardia (pulse rate of 120 beats/min) with normal blood pressure and respiratory rate. Although the patient had received three units of packed red blood cells on previous day, hemoglobin level (Hb) was 8 g/dl at admission time. Computed tomography showed a large presacral hematoma measuring 117 × 86 × 71 mm and extending to the perineal area. with extension to perineal area. After transfusion of a total of five units of packed red blood cells, with regard to optimal response to conservative management, normal vital sign and decreased abdominopelvic pain and discomfort, there was no need for further therapeutic interventions such as embolization or surgical management.
Conclusion: Using imaging modalities for accurate diagnosis, retroperitoneal hematoma could be managed with conservative treatment.