Atypical graft infection presenting as a remote draining sinus.
BACKGROUND
Synthetic materials are being used increasingly in reconstructive pelvic surgery. Multifilament polypropylene mesh in particular has been associated with healing abnormalities and other postoperative complications. This article describes an atypical infection presenting as a draining sinus tract to the lower extremity after intravaginal slingplasty.


METHODS
An otherwise healthy 75-year-old-woman presented with recurrent leg cellulitis 18 months after posterior intravaginal slingplasty for vaginal vault prolapse. A 35-cm fistulous tract draining from the pelvis to the lower thigh was identified. The patient underwent surgical debridement and was treated with 12 weeks of intravenous antibiotics with complete healing and no recurrence of symptoms.


CONCLUSIONS
Complications associated with the multifilament mesh used in the intravaginal slingplasty tunneler device include pain, erosion, localized abscess, and genitourinary fistula.
Karp
Deborah
D
From the Cleveland Clinic Florida, Urogynecology and Pelvic Reconstructive Surgery, Weston, Florida; and the Winthrop University Hospital, Department of Obstetrics and Gynecology, Mineola, New York.
Apostolis
Costas
C
Lefevre
Roger
R
Davila
G Willy
GW
D000368:Aged; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D011126:Polypropylenes; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D053825:Suburethral Slings / Q000009:adverse effects*; D014596:Uterine Prolapse / Q000601:surgery*
D011126:Polypropylenes