title: Groin granuloma formation after midurethral sling.
abstract: BACKGROUND
  Complications of midurethral transoburator slings include injuries directly associated with trocar placement or subsequent erosion of the mesh that is placed. While tissue reaction to implanted mesh material occurs, rarely does it produce clinical symptoms. We report a case of granuloma formation after a transobturator tape midurethral sling presenting as a groin mass.
  
  
  METHODS
  A 59-year-old para 2 postmenopausal woman underwent uncomplicated placement of a transobturator tape midurethral sling concomitantly with prolapse repair. Two years later, she presented to her primary care physician complaining of a 1-cm groin mass. After failure of empiric treatment with antibiotics for a presumed infectious etiology, surgical resection of the mass was performed, which revealed granuloma formation surrounding the polypropylene mesh.
  
  
  CONCLUSIONS
  Granuloma formation can occur years after placement of a midurethral transobturator sling. Whereas a rare complication, it is important for surgeons to consider this diagnosis during the workup of a groin mass.
authors: Center of Urogynecology and Pelvic Floor Disorders, Cleveland Clinic, Cleveland, OH, USA. kown@ccf.org
authors: Nathan
authors: N
authors: Kow
authors: Mark D
authors: MD
authors: Walters
mesh_terms: D005260:Female; D015745:Granuloma, Foreign-Body / Q000453:epidemiology*; D006119:Groin; D006801:Humans; D008875:Middle Aged; D010808:Physical Examination; D053825:Suburethral Slings / Q000009:adverse effects*; D013526:Surgical Mesh