Midurethral slings (MUSs) have been used successfully for the last 20 years in the treatment of stress urinary incontinence and accepted as the gold standard surgical procedure. High success rates and minimal invasiveness of surgery are among the most important advantages, but sometimes serious complications can occur during or after surgery. Although serious complications are rare after widely performed transobturator tape (TOT) operation, awareness, early diagnosis, and aggressive management are essential as they can progress with serious morbidity and mortality. In order to reduce the infectious complications after MUS procedures, in addition to sterility of the operating theater and the operating equipment, the type of mesh used and the preparation of the surgical site are crucial. We aimed to pre-sent the successful management of a case of necrotizing fasciitis in a TOT patient.

1.
Jonsson Funk
M
,
Levin
PJ
,
Wu
JM
.
Trends in the surgical management of stress urinary incontinence
.
Obstet Gynecol
.
2012
;
119
(
4
):
845
51
.
2.
Bako
A
,
Dhar
R
.
Review of synthetic mesh-related complications in pelvic floor reconstructive surgery
.
Int Urogynecol J Pelvic Floor Dysfunct
.
2009
;
20
(
1
):
103
11
.
3.
Choi
H
,
Bae
JH
,
Lee
JG
.
Severe thigh abscess two years after transobturator sling operation
.
Low Urin Tract Symptoms
.
2011
;
3
(
1
):
51
4
.
4.
Grigoriadis
T
,
Zacharakis
D
,
Kontogeorgakos
V
,
Protopapas
A
,
Vogiatzis
N
,
Athanasiou
S
.
Radical excision of a complicated transobturator tape
.
Int Urogynecol J
.
2019
;
31
(
4
):
831
3
.
5.
Kerbaj
J
,
Aubry
C
,
Prost
C
,
Brouqui
P
.
Thigh abscess and necrotizing fasciitis following an inside-out transobturator tape intervention: a case report
.
J Med Case Rep
.
2016
;
10
(
1
):
146
.
6.
Maffiolini
M
,
Asteria
CR
.
A cutaneous-vaginal fistula and myositis of the obturator muscle following placement of a trans-obturator tape for stress incontinence
.
Eur J Obstet Gynecol Reprod Biol
.
2010 Apr
;
149
(
2
):
225
6
.
7.
Breyre
A
,
Frazee
BW
.
Skin and soft tissue infections in the emergency department
.
Emerg Med Clin North Am
.
2018
;
36
(
4
):
723
50
.
8.
Abouassaly
R
,
Steinberg
JR
,
Lemieux
M
,
Marois
C
,
Gilchrist
LI
,
Bourque
JL
, et al.
Complications of tension-free vaginal tape surgery: a multi-institutional review
.
BJU Int
.
2004
;
94
(
1
):
110
3
.
9.
Deffleux
X
,
Letouzey
V
,
Savary
D
,
Senthilhes
L
,
Agostini
A
,
Mares
P
, et al.
[Prevention of the complications related to the use of prosthetic meshes in prolapse surgery: guidelines for clinical practice: text of the guidelines]
.
J Gynecol Obstet Biol Reprod
.
2012
;
40
(
8
):
851
3
.
10.
Rardin
CR
,
Moore
R
,
Ward
RM
,
Myers
DL
.
Recurrent thigh abscess with necrotizing fasciitis from a retained transobturator sling segment
.
J Minim Invasive Gynecol
.
2009
;
16
(
1
):
84
7
.
11.
Mahal
AS
,
Bradley
CS
.
Necrotizing postsurgical infection complicating midurethral sling procedure with unrecognized cystotomy
.
Female Pelvic Med Reconstr Surg
.
2012
;
18
(
3
):
183
5
.
12.
Johnson
DW
,
ElHajj
M
,
OBrien-Best
EL
,
Miller
HJ
,
Fine
PM
.
Necrotizing fasciitis after tension-free vaginal tape (TVT) placement
.
Int Urogynecol J Pelvic Floor Dysfunct
.
2003
;
14
(
4
):
291
3
.
13.
Flam
F
,
Boijsen
M
,
Lind
F
.
Necrotizing fasciitis following transobturator tape treated by extensive surgery and hyperbaric oxygen
.
Int Urogynecol J Pelvic Floor Dysfunct
.
2009
;
20
(
1
):
113
5
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.