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Injury of the corona mortis during vaginal tape insertion (TVT-Secur™ using the U-Approach)

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Abstract

Introduction and hypothesis

We report a serious bleeding complication due to injury of the corona mortis following insertion of a transvaginal tape, TVT-Secur™ (Ethicon Women's Health, Sommerville, NJ, USA).

Methods

The TVT-Secur™ was inserted using the U-Approach: the tape was pushed along the periost behind the arc of the pubic bone at an angle of 45°.

Results

Surgery was unproblematic. Four hours after surgery, the patient showed shock signs; a CT scan revealed a 13.5 × 9.5-cm-sized retrosymphysic haematoma. Instant laparotomy with removal of the large haematoma, ligation of the bleeding corona mortis and administration of erythrocyte concentrates were necessary.

Conclusion

The corona mortis is an anastomosis between the arteria obturatoria and the external iliac vessels or its branches that passes over the superior pubic ramus. Its prevalence and anatomical relation to the pubic bone are important to bear in mind when applying new surgical techniques.

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References

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Conflicts of interest

None.

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Authors and Affiliations

  1. Bürgerspital Solothurn, 4500, Solothurn, Switzerland

    Ursula Gobrecht & Bernhard Fellman

  2. Universitätsklinik für Frauenheilkunde, Inselspital, CH-3010, Bern, Switzerland

    Annette Kuhn

Authors
  1. Ursula Gobrecht
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  2. Annette Kuhn
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  3. Bernhard Fellman
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Corresponding author

Correspondence to Ursula Gobrecht.

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Gobrecht, U., Kuhn, A. & Fellman, B. Injury of the corona mortis during vaginal tape insertion (TVT-Secur™ using the U-Approach). Int Urogynecol J 22, 443–445 (2011). https://doi.org/10.1007/s00192-010-1355-2

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  • DOI: https://doi.org/10.1007/s00192-010-1355-2

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