Transobturator tape수술 후 발생한 자궁동맥출혈에서 자궁동맥색전술을 이용한 성공적 치료 1예
Uterine artery embolization for the management of uterine artery bleeding after transobturator tape operation: A case report
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초록
Transobturator Tape (TOT) 시술은 기존의 Tension free vaginal tape (TVT)의 합병증을 줄이기 위해 고안된 요실금 치료방법으로 좋은 치료 성적과 적은 합병증으로 최근 널리 사용되고 있다. 그러나 TOT 시술의 경우도 여타 합병증 및 폐쇄공을 통한 시술경로에 따른 독특한 합병증이 발생할 수 있으므로 이에 대한 주의가 요구된다. TOT 시술 후 발생한 합병증으로 자궁 동맥손상은 국내외적으로 보고 된 바가 없다. TOT 시술과 관련하여 드물지만 본 증례처럼 저혈 성 쇼크와 혈액응고장애를 일으킬 정도의 심각한 출혈을 일으키는 합병증도 일으킬 수 있음을 숙지하고 즉각적인 대처가 필요할 것으로 생각된다. 저 자들은 34세의 여성에서 TOT 시술 후 발생한 자궁동맥 손상의 드문 증례를 경험하고 이를 자궁동맥색전술을 이용하여 성공 적으로 치료하였기에 간단한 문헌고찰과 함께 보고하는 바이다.
Abstract
Transobturator tape (TOT) operation for urinary stress incontinence is associated with less complication rate than Tension free vaginal tape (TVT). The two procedures yield similar rates of success. The TOT is lead through the obturator foramen, reducing the risk of bladder injury as well as damage of structures located in the Retzii cave, e.g. nerves and blood vessels. However the complications of TOT procedure may have several complications associated with obturator foramen. They are the injury of obturator nerve and vessels, abscess formation on th obturator foramen, vulvar hematoma, etc. There is no report the uterine artery injury after TOT procedure so far. Recently we experienced a case of successful control of bleeding of the uterine artery after TOT operation via uterine artery embolization. Therefore we report our case with brief review of the literatures.
참고문헌 (18)
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