International Urogynecology Journal

, Volume 31, Issue 1, pp 215–217 | Cite as

Management of presacral bleeding

  • Erik D. HokenstadEmail author
  • John A. Occhino
IUJ Video


Introduction and hypothesis

The objective of this video is to demonstrate a variety of available techniques that can be used in the management of acute presacral bleeding.


In this video, we demonstrate different methods for the management of presacral bleeding utilizing a fresh frozen cadaver.


Presacral bleeding is a potentially catastrophic complication that can be encountered during pelvic surgery, particularly sacrocolpopexy. Various techniques exist to achieve hemostasis in the event of uncontrolled bleeding. This video demonstrates some of the available methods that may be employed in the management of presacral bleeding. The methods demonstrated in this video include direct pressure, pelvic packing, gelatin matrix, bone wax, thumb tack, surgical clip, suture, oxidized regenerated cellulose, omental flap, electrocautery, muscle fragment welding, gelatin matrix combined with thrombin, and microporous polysaccharide spheres.


Familiarity with these techniques and product availability will aid in the management of acute presacral bleeding.


Presacral bleeding Pelvic surgery Simulation 


Compliance with ethical standards

Conflicts of interest



Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

Supplementary material


(MP4 97153 kb)


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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Division of UrogynecologyMayo ClinicRochesterUSA

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