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Groin Granuloma Formation After Midurethral Sling

Kow, Nathan MD; Walters, Mark D. MD

Female Pelvic Medicine & Reconstructive Surgery:
doi: 10.1097/SPV.0b013e31827cd3c5
Case Reports
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.

Case: 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.

Conclusion: 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.

In Brief

Granuloma formation of mesh placed for midurethral transobturator sling can present as a groin mass.

Author Information

From the Center of Urogynecology and Pelvic Floor Disorders; Obstetrics, Gynecology & Women’s Health Institute, Cleveland Clinic, Cleveland, OH.

Reprints: Nathan Kow, MD, Female Pelvic Medicine and Reconstructive Surgery, Center of Urogynecology and Pelvic Floor Disorders, Desk A-81, Obstetrics, Gynecology, & Women’s Health Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195. E-mail: kown@ccf.org or nathankow@gmail.com.

Mark D. Walters is a lecturer for American Medical Systems and receives research support from Ethicon Gynecare.

The authors have declared they have no conflicts of interest.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins