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Perineal Abscess Three Years After a Transobturator Sling

Moroni, Rafael Mendes MD; Magnani, Pedro Sergio MD; Carvalho, Maria Angela Cury Ramos MD; Candido dos Reis, Francisco Jose MD, PhD; Brito, Luiz Gustavo Oliveira MD, PhD; Sabino-de-Freitas, Mauricio Mesquita MD, PhD

Female Pelvic Medicine & Reconstructive Surgery: May/June 2014 - Volume 20 - Issue 3 - p 174–176
doi: 10.1097/SPV.0b013e318286bc4f
Case Report

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.

Case Report 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.

Discussion 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.

Perineal abscess after placement of a transobturator sling without mesh exposure may appear after patient immunossupression.

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.

Reprints: Luiz Gustavo Oliveira Brito, MD, PhD, Hospital das Clínicas da FMRP-USP, Avenida Bandeirantes, 3900, 8th floor, Ribeirao Preto, São Paulo, Brazil. E-mail: lgobrito@gmail.com.

The author has declared that there are no conflicts of interest.

Perineal abscess after placement of a transobturator sling without mesh exposure may appear after patient immunossupression.

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