Small-pore polypropylene slings: still out there.
We report on a case of a suburethral erosion of transobturator tape tracking into the right thigh with abscess formation 20 months from surgery resulting in necrotizing fasciitis. A 64-year-old woman presented with new onset of severe right thigh pain. Physical exam was concerning for a right thigh abscess and she was admitted to general surgery for evaluation. Gynecology was consulted secondary to a complaint of foul vaginal discharge. The patient was noted to have a vaginal mass on the anterior vaginal wall. A computed tomography scan showed a large right medial thigh abscess. The patient was taken for emergency exploratory surgery where an ObTape (Mentor, Santa Barbara, CA, USA) TOT was found eroding through the anterior vaginal wall, extending into the thigh abscess. During removal of the ObTape from her thigh, the entire gracilis muscle was removed due to necrotizing fasciitis and extensive tissue debridement was performed. A wound vac was placed and the patient had an uneventful recovery.
Lowery
William J
WJ
Department of Obstetrics and Gynecology, San Antonio Uniformed Services Health Education Consortium, 3851 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX 78234, USA. william.lowery@amedd.army.mil
Dooley
Yashika
Y
Kost
Edward
E
D020878:Device Removal; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes; D053825:Suburethral Slings / Q000009:adverse effects*; D013848:Thigh / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019522:Vaginal Discharge / Q000209:etiology
D011126:Polypropylenes