Acute postoperative delayed hemorrhage following anterior colporrhaphy and cystoscopy: A case report and a review of the literature

The development of a retroperitoneal hematoma is a rare complication in gynecologic surgery. The literature on the condition is largely in the form of case reports describing its occurrence in relation to vaginal procedures. We report the case of a 40-year-old woman who had acute delayed-onset postoperative hemorrhage and retroperitoneal hematoma formation following an uncomplicated anterior colporrhaphy. She re-presented to the hospital several hours after discharge, with severe pain and vaginal bleeding. On imaging, she was found to have a large pelvic hematoma that was displacing the uterus, with extraperitoneal free fluid and active contrast extravasation. She underwent resuscitation and successful coil embolization of a small branch of the right uterine artery. This case report adds to the body of literature on the occurrence of retroperitoneal hematoma in vaginal surgery and underscores the importance of maintaining a high index of suspicion in individuals presenting with signs or symptoms suggestive of this diagnosis.