Description of Event or Problem · 1
A FEMALE WAS REFERRED TO THE ORTHOPEDIC ONCOLOGY SERVICE BY HER PRIMARY PHYSICIAN WITH COMPLAINTS OF PERSISTENT PAIN AND A LEFT MEDIAL THIGH MASS ONE YR AFTER AN OBTAPE TRANSOBTURATOR SLING PROCEDURE (MENTOR CORP.) FOR STRESS URINARY INCONTINENCE. SIX MONTHS AFTER THE PROCEDURE, SHE FELT TIGHTNESS IN THE VAGINA, DYSPAREUNIA, AND NOTED A BULGE IN HER MEDIAL THIGH. MULTIPLE MUSCLE BIOPSIES OF THE ENLARGING MASS WERE INCONCLUSIVE, RAISING CONCERN FOR INFLAMMATORY SARCOMA. INCISION AND DRAINAGE FOR PERSISTENT PAIN FINALLY ESTABLISHED THE PRESENCE OF A THIGH ABSCESS. AFTER INTRAVENOUS ANTIBIOTICS, WOUND VACUUM, AND MULTIPLE WOUND DEBRIDEMENTS, SLING MATERIAL WAS FOUND IN THE OBTURATOR SPACE REVEALING THE THIGH ABSCESS AS A COMPLICATION OF THE TRANSOBTURATOR SLING. THE PT WAS REFERRED TO UROGYNECOLOGY FOR EVALUATION AND EXCISION OF THE SLING. PRE-OPERATIVE CIPROFLOXACIN AND METRONIDAZOLE WERE GIVEN, AND COPIOUS IRRIGATION WAS PERFORMED OF THE ANTERIOR VAGINA. EXAMINATION UNDER ANESTHESIA REVEALED EXPOSED MESH.