title: Transobturator tape removal using a combined vaginal-transcutaneous approach for intractable groin pain.
abstract: BACKGROUND
  : Transient groin pain is a therapeutically challenging complication associated with transobturator sling procedures.
  
  
  METHODS
  : We present the case of a 37-year-old woman who presented with debilitating left groin pain and dyspareunia following placement of transobturator sling. Pelvic floor physical therapy, medications, and trigger point injections failed to provide relief. Workup included magnetic resonance imaging of the pelvis, complex cystometrics, and additional trigger point injections. Surgical removal of the complete left side of the tape including the portion imbedded in the obturator foramen was performed with a combined vaginal-transcutaneous approach. Extirpation of the mesh arm brought prompt and full resolution of the patient's symptoms.
  
  
  CONCLUSIONS
  : Surgical removal of the transobturator tape through the obturator foramen can be safely performed using a combined vaginal-transcutaneous approach.
authors.affiliation: From the Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Gruber
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Hernandez
authors.forename: Johnnie
authors.initials: J
authors.lastname: Wright
authors.forename: John R
authors.initials: JR
authors.lastname: Fischer