Korean J Urol.  2010 Sep;51(9):657-659.

Bilateral Recurrent Thigh Abscesses for Five Years after a Transobturator Tape Implantation for Stress Urinary Incontinence

• Lee SY
• Kim JY
• Park SJ
• Kwon YW
• Nguyen HB
• Chang IH
• Kim TH
• Kim YS

Abstract

The synthetic, tension-free midurethral sling procedure using transobturator tape (TOT) was introduced in 2001 and has become the most widely used procedure for the treatment of female urinary incontinence worldwide. However, infectious complications associated with erosions have occasionally been reported because of a foreign body reaction to the polypropylene mesh. We observed a case of a bilateral recurrent thigh abscess manifesting 5 years after a TOT sling procedure. The patient had recurrent thigh abscesses with repeated incisions and drainages in the past 1 year. Five months earlier, she had undergone a procedure to remove the eroded suburethral mesh, but incompletely. The right thigh abscess recurred, and ultimately the residual mesh was completely excised with abscess drainage. Complete mesh removal is very important to prevent abscess recurrence, and it is necessary for any urologist treating women who have undergone the TOT procedure to be aware of the possibility of abscesses occurring for a long time after the operation.

Keyword

Abscess; Stress urinary incontinence; Suburethral slings

MeSH Terms

Abscess
Cytochrome P-450 CYP1A1
Drainage
Female
Foreign-Body Reaction
Humans
Polypropylenes
Recurrence
Suburethral Slings
Thigh
Urinary Incontinence
Cytochrome P-450 CYP1A1
Polypropylenes

Figure

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  FIG. 1 Computed tomography (CT) of the thigh on admission. Transverse (A) and coronal (B) views showing an approximately 2.5×3×3 cm sized abscess (arrows), located in between the adductor magnus and gracilis muscles.

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  FIG. 2 Ultrasonography of the thigh on the sixth day of admission. The size of the abscess pocket (asterisk) was increased and severe muscular swelling was observed.

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