Perineal abscess three years after a transobturator sling.
OBJECTIVE
This study aimed to report a unique perineal abscess after placement of a transobturator sling, involving the thighs and obturator regions bilaterally without involving mesh exposure.


METHODS
A 66-year-old woman treated for stress urinary incontinence with a transobturator sling developed a late bilateral obturator infection 30 months after surgery. This complication appeared 6 months after chemotherapy for breast cancer. Sling removal through vaginal and bilateral inguinal incisions was performed. The patient evolved well, without recurrence of the infection or incontinence.


CONCLUSIONS
This case presents a unique scenario of muscle and skin infection after sling placement without any mesh exposure or vaginal involvement. The occurrence of the infection only after chemotherapy may indicate that immunosuppression had participation on its development. Care should be taken when exposing this mesh in contaminated perineal areas.
From the Urogynecology, Gynecological and Pelvic Reconstructive Surgery Division, Department of Gynecology and Obstetrics, Ribeirao Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Rafael Mendes
RM
Moroni
Pedro Sergio
PS
Magnani
Maria Angela Cury Ramos
MA
Carvalho
Francisco Jose
FJ
Candido Dos Reis
Luiz Gustavo Oliveira
LG
Brito
Mauricio Mesquita
MM
Sabino-de-Freitas
D000038:Abscess / Q000209:etiology*; D020878:Device Removal; D013293:Enterococcus faecalis; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000209:etiology*; D006801:Humans; D010502:Perineum; D016459:Prosthesis-Related Infections / Q000209:etiology*; D012008:Recurrence; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery