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Transobturator Tape Removal Using a Combined Vaginal-Transcutaneous Approach for Intractable Groin Pain

Gruber, Daniel D. MS, MD; Hernandez, Sandra L. MD; Wright, Johnnie Jr MD; Fischer, John R. MD

Female Pelvic Medicine & Reconstructive Surgery: January/February 2011 - Volume 17 - Issue 1 - pp 55-57
doi: 10.1097/SPV.0b013e318204490c
Case Report

Background: Transient groin pain is a therapeutically challenging complication associated with transobturator sling procedures.

Case: 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.

We present a case of intractable groin pain from a TVT-O and describe the technique for complete removal of the entire tape from the affected side, which resulted in pain resolution.

From the Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC.

The authors have no conflicts of interest to disclose. No funding was received.

The views expressed in this article are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the US government.

Reprints: Daniel Gruber, MS, MD, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, 6900 Georgia Ave, NW Washington DC 20307. E-mail: ddgruber1@gmail.com.

© 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins