Severe Thigh Abscess Two Years after Transobturator Sling Operation.

Abstract

Tension-free vaginal tape has gained large popularity owing to the ease of the procedure and its effectiveness. These procedures were initially thought to rarely involve any significant morbid complications. The transobturator tape (TOT) procedure reproduces the natural suspension similar to the tension-free vaginal tape with a reduction in potential bladder, bowel, and vascular complications by the retropubic approach. However, the TOT procedure is not risk-free when improperly performed. We report a rare case of abscess formation after TOT. A 45-year-old woman was admitted to the orthopedic department with the chief complaint of right side thigh pain and swelling. Pelvis MRI showed abscess formation and inflammatory changes extending into the soft tissues and muscles between the right gracilis and adductor femoris. During incision and open drainage, the remnant mesh could not be located. On urologic consult, the pelvic examination located the remnant mesh to the right upper vaginal wall. Our patient underwent excision of the mesh material. She had significant improvement of the leg pain and was discharged home in good condition on postoperative day 7. Ultimately, the treatment for this complication was the removal of the mesh. Treatment for thigh abscess after TOT was the removal of the mesh. All patients should be counseled about this potential complication.