Severe soft tissue infection.pdfVIP

Int Urogynecol J (2007) 18: 207–212 DOI 10.1007/s00192-006-0129-3 REVIEW ARTICLE Gilles Karsenty . Jason Boman . Ehab Elzayat Marie-Claude Lemieux . Jacques Corcos Severe soft tissue infection of the thigh after vaginal erosion of transobturator tape for stress urinary incontinence Received: 14 February 2006 / Accepted: 17 March 2006 / Published online: 24 May 2006 # International Urogynecology Journal 2006 Abstract Since the beginning of use of synthetic mid- urethral slings, several complications, usually benign, have been reported. Recently, three consecutive cases of severe thigh infection secondary to transobturator insertion of a synthetic tape alarmed us. This is a case report about these three cases and a review of literature about complications of transobturator tapes. Keywords Urinary incontinence . Complications . Transobturator tape . Slings . Abscess . Fournier’s gangrene Introduction After Ulmsten’s first description [1], midurethral synthetic tapes have been widely used for the treatment of stress urinary incontinence (SUI) in women. To decrease the risk of bladder, digestive, or vascular injuries associated with the retropubic route, Delorme [2] promoted the obturator foramen route, which was later modified by de Leval [3]. Transobturator tapes (TOT) were widely used in North America for the last 18–24 months and three cases of severe thigh infections were referred to our tertiary care center in the last 6 months. Alarmed by these severe and unusual complications after urinary incontinence surgical corrections with midurethral synthetic tapes, we reviewed the literature and report on our experience. Materials and methods Three patients with soft tissue infection of the thigh after TOT insertion for SUI were referred, treated, and followed prospectively at our tertiary incontinence center. TheMedline database was searched for similar cases from January 1994 (date of the first description of midurethral synthetic tape) to October 2005. The terms infect