Profuse Bleeding Following Interstitial Brachytherapy (ISBT) for Cervical Cancer Requiring Surgical Intervention

Summary: Majority of vaginal bleeding cases are successfully managed with packing. In rare cases, traditional measures do not achieve adequate bleeding control. Even if angiography did not show any obvious vascular injury, the embolization of the bilateral internal iliac arteries successfully controlled the hemorrhage. Multiple topical options exist for controlling vaginal bleeding. These include Mohs’ paste, Monsel’s solution (ferric subsulfate) and 4% formalin. However, when these options fail to be effective, embolization of the internal iliac arteries could be a valid option to control vaginal bleeding, even when angiography does not show vascular injury.