Perineal cellulitis and persistent vaginal erosion after transobturator tape (Obtape)—case report and review of the literature

Abstract

Transobturator sub-urethral tapes are emerging as one of the surgical options for the management of urodynamic stress incontinence. Though with relatively less risk of injury to the bladder, a different approach as well as the different characteristics of the tape material mean a variety of complications like obturator abscess, obturator haematoma, retro-pubic haematoma, and perineal cellulitis. In this paper, we describe a case of perineal cellulitis following the insertion of a transobturator tape (Obtape). Though cellulitis was managed conservatively with intravenous antibiotics, the patient was found to have vaginal extrusion of the tape. Vaginal erosion was initially managed with resuturing of the vaginal wall. Persistent erosion unfortunately necessitated complete tape removal. The patient later had another sub-urethral procedure after 3 months. Perineal cellulitis is rare after transobturator tape procedures. In the literature, only two cases have been described so far. Though vaginal erosion can be managed conservatively, we recommend the complete removal of the tape when an infection is proven or suspected.

Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations

“…Different therapeutic approaches are present. Some authors recommend conservative approach on the other hand some authors recommend partial or total excision of the mesh (34)(35)(36). In our study, partial excision of mesh was performed in 2 of the patients with vaginal erosion after mesh application and total excision was performed in one patient.…”

Skin and vaginal erosion after adjustable miduretral sling operation

“…Günümüzde önerilen meş, makropor (>75 mikron), monoflaman, poliprolen sentetik meştir [15]. Erozyon tedavisinde bazı çalışmalarda konservatif yaklaşım önerilmektedir [16,17]. Bazı çalışmalarda ise enfeksiyöz komplikasyon riski nedeniyle erozyon varlığında hemen meşin tamamen çıkarılması önerilmektedir [18,19].…”

A standardized description of graft-containing meshes and recommended steps before the introduction of medical devices for prolapse surgery

“…An early warning would have avoided the disastrous results of using these products by unsuspecting physicians. In the absence of such a registry (and appropriate action by the authorities and/or industry), one has to wait for publications reporting a higher than expected incidence of these events, which by definition will be published later than the initial first 12 months of use [64][65][66]. Early detection would have prevented the substantial morbidity from the uncontrolled use of this product.…”