Perineal cellulitis and persistent vaginal erosion after transobturator tape (Obtape)--case report and review of the literature.
Transobturator sub-urethral tapes are emerging as one of the surgical options for the management of urodynamic stress incontinence. Though with relatively less risk of injury to the bladder, a different approach as well as the different characteristics of the tape material mean a variety of complications like obturator abscess, obturator haematoma, retro-pubic haematoma, and perineal cellulitis. In this paper, we describe a case of perineal cellulitis following the insertion of a transobturator tape (Obtape). Though cellulitis was managed conservatively with intravenous antibiotics, the patient was found to have vaginal extrusion of the tape. Vaginal erosion was initially managed with resuturing of the vaginal wall. Persistent erosion unfortunately necessitated complete tape removal. The patient later had another sub-urethral procedure after 3 months. Perineal cellulitis is rare after transobturator tape procedures. In the literature, only two cases have been described so far. Though vaginal erosion can be managed conservatively, we recommend the complete removal of the tape when an infection is proven or suspected.
Sivanesan
Kanapathippillai
K
Department of Obstetrics and Gyneacology, Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK. sivanesank@doctors.net.uk
Abdel-Fattah
Mohamed
M
Tierney
John
J
D002481:Cellulitis / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010502:Perineum; D011475:Prosthesis Failure; D012086:Reoperation; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014623:Vaginal Diseases / Q000209:etiology*