Kannan, K., and Rane, A. (2010) Pelvic haematoma after Perigree TM procedure for cystocele. Journal of Obstetrics and Gynaecology, 30 (5). pp. 524-525.

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Abstract

Pelvic organ prolapse (POP) is seen in 50% of parous women, with the lifetime risk of surgery by the age of 80 years of 11.1% (Olsen et al. 1997). Cystocoele or anterior vaginal wall prolapse is the most common pelvic organ prolapse involving descent of the bladder (Hendrix et al. 2002; Eva et al. 2003). Traditionally, anterior colporrhaphy with native tissue plications has been the procedure of choice among gynaecologists, and success rates have been reported as between 80 and 100% (Stanton et al. 1982). The high failure rate could be attributed to plicating an already weakened tissue.

Over the last decade, there has been tremendous interest in the use of mesh in pelvic reconstructive surgery, in order to obtain a higher success rate. Various types of mesh – biological and synthetic – have been used with differing success rates. However, with the increasing usage, researchers are trying to establish safety, efficacy and the complications arising out of mesh usage in corrective surgery. Some of the complications reported include mesh exposure, mesh infection, dyspareunia and haemorrhagic complications.

The purpose of this report is to highlight a case of a large pelvic haematoma, a rare complication following the insertion of the transobturator mesh, Perigee system, for correcting a grade 3(POP-Q) cystocoele.

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