Large Retroperitoneal Hematoma after Vaginal Cystocele Repair: A Case Report

Pourali, Leila; Vatanchi, Atiyeh; Aminzadeh, Behzad; Armanpour, Samira

doi:10.22038/jmrh.2025.73095.2136

Large Retroperitoneal Hematoma after Vaginal Cystocele Repair: A Case Report

Articles in Press

Document Type : Case Report

Authors

Leila Pourali ¹

Atiyeh Vatanchi ¹

Behzad Aminzadeh ²

Samira Armanpour ²

¹ Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

² Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/jmrh.2025.73095.2136

Abstract

Introduction: Anterior colporrhaphy with native tissue repair is a common gynecological surgery performed to correct the anterior vaginal wall prolapse. Retroperitoneal hematoma is a rare complication in this situation. This study aimed to introduce a rare case of retroperitoneal hematoma after vaginal cystocele repair.
Case presentation: This study presents a 33-year-old woman with abdominal pain and pelvic pressure referred to the Gynecology Emergency Unit. She underwent vaginal cystocele repair in another hospital the previous day. In postoperative recovery room, the patient complained of severe pelvic pain. Vaginal examination showed tenderness and bulging with a large ecchymotic area around labia majora that extended to the buttock. The vital sign at the admission time in our hospital showed tachycardia (PR=120/m) with normal blood pressure and respiratory rate. Although she had received 3 units of packed cell at the first hospital at the previous day, the Hemoglobin level (HB) was 8 mg/dl at admission time in our hospital. Computed tomography showed large hematoma in presacral space with 117×86×71 cm in size at pre sacral space with extension to perineal area.
After totally infusion of 5 units of packed cells, with regard of the optimal response to the conservative management, normal vital sign and decreased abdominopelvic pain and discomfort, there was no need for other therapeutic interventions; like embolization or surgical modalities.
Conclusion: Retroperitoneal hematoma is one of the rare complications in vaginal surgeries that can cause severe abdominal and pelvic pain with hemodynamic changes. However by the use of imaging modalities for acurrate diagnosis, retroperitoneal hematoma could be managed with conservative treatment.

Keywords

Hematoma

Complication

Hemorrhage

Vaginal

Prolapse

Subjects