The use of vascular clips to minimize blood loss in colpourethropexy.

A serious intraoperative and postoperative complication associated with colpourethropexy as described by Burch and Tanagho and others is hemorrhage. We performed the Tanagho modification of the Burch procedure in 13 patients, as the sole procedure in the treatment of genuine stress incontinence. Vascular clips were used to circumscribe the fat overlying the anterior part of the vaginal wall, thereby allowing en bloc resection of the vascular fat pad. Suspensory sutures of 1-0 Vicryl (polyglactin 910) were placed; no retroperitoneal drains were used. The blood loss was estimated to be less than 50 milliliters in ten instances and less than 75 milliliters in three. The average hospital stay was 4.2 days. All of the patients were given antibiotic prophylaxis and were discharged home with suprapubic drainage of the bladder. There were no intraoperative or postoperative complications. Thus, one of the serious complications of colpourethropexy can be avoided by using vascular clips to facilitate the removal of the periurethral and paravesical fat from the anterior part of the vaginal wall.