A very rare case of delayed catastrophic arterial bleed post-vaginoplasty

Uma Walters; Helena Gresty; Manjit Takhar; Martina Zurli; Mohammad Daneshi; Tina Rashid

doi:10.1016/j.eucr.2019.101089

A very rare case of delayed catastrophic arterial bleed post-vaginoplasty

Urol Case Rep. 2019 Dec 11:29:101089. doi: 10.1016/j.eucr.2019.101089. eCollection 2020 Mar.

Authors

Uma Walters¹, Helena Gresty¹, Manjit Takhar¹, Martina Zurli¹, Mohammad Daneshi², Tina Rashid¹

Affiliations

¹ Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
² Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Abstract

The gold standard for male to female genital reconstruction in the UK is vaginoplasty with penile and/or scrotal skin for neovagina formation. We present a rare case of a major haemorrhage in a 46-year-old patient, 26 days post-vaginoplasty. An urgent computed tomography scan identified a large retrovesical collection, with high-density contents in keeping with recent haemorrhage, containing a 6mm pseudoaneurysm within the right lateral wall. Following resuscitation, the patient was urgently treated with successful embolization of the feeding artery (branch of the prostatic artery), with pushable coils. We highlight the importance of expedient, life-saving management in a rare post-operative complication.

Keywords: Arterial embolization; Gender reassignment surgery; Genital reconstruction; Pseudoaneurysm; Sex reassignment surgery; Vaginoplasty.

Publication types

Case Reports