Abscess of the thigh and psoas muscle after transobturator suburethral sling procedure

Safety considerations for synthetic sling surgery

“…151 Other more serious infections have been reported after SMUS implantation. In a comprehensive literature review 45 several such complications following sling placement were reported: cellulitis; [117][118][119][120][121]187 abscess formation, including in the retropubic space, 122 retroperitoneal space, 123 thigh, 123 obturator space [124][125][126] and ischiorectal fossa; 127,128 sinus tract formation; 129 necrotizing fa sciitis; 130 osteitis pubis; 131 and sepsis. 12 Thigh abscesses, a complication unique to the TOT sling approach, have been reported in the past decade.…”

“…We, and others, have noted that the infection can track along muscle planes and even form a psoas muscle abscess in some patients. 123,191 These abscesses might require multiple operations in order to achieve a satisfactory outcome. Unfortunately, owing to the technical reasons explained above and concerns about complications in adjacent organs during the dissection, complete mesh removal is often not accomplished in patients with type I mesh slings.…”

“…In addition, we estimate that bowel perforation and serious infections have a combined incidence of about 0.1%. [117][118][119][120][121][122][123][124][125][126][127][128][129][130][131][132][133][134] Refractory and potentially lifestyle-altering complications include chronic pain (4.1%) and de novo overactive bladder (OAB) in 11% (Table 5), although the number of patients with de novo OAB who are refractory to treatment remains unknown. Evidence suggests that well over 50% of patients with OAB of any aetiology discontinue medical treatment within 1 year, owing to a combination of poor effectiveness and low tolerability.…”

“…12 Thigh abscesses, a complication unique to the TOT sling approach, have been reported in the past decade. 101,123,188,189 Occurrence of such serious SMUS-related infectious complications is often delayed by months or years after sling implantation. Presenting symptoms include chronic discharge from the vagina, thigh and/or perineum.…”

Biomaterials in urinary incontinence and treatment of their complications

“…These range from urinary tract infections,[62] abscess formation in an assortment of anatomical spaces (thigh to ischiorectal fossa), as well as fistulas, necrotizing fasciitis, osteitis pubis and systemic sepsis, and urinary tract infection. [566364] Infectious complications may be delayed by several months or years after the sling procedure.…”