Groin abscess secondary to trans obturator tape erosion: case report and literature review
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Published on: March 2, 2020
1Academic Department of Obstetrics and Gynaecology, Gledhow Wing, St. James's University Hospital, Beckett Street, Leeds, United Kingdom.
Aims:
To report a case of groin abscess secondary to trans obturator tape erosion and review the literature on the incidence, predisposing factors, symptoms and management of tape erosion.
Methods:
The clinical history, operative details, postoperative symptoms, findings and management of this case are reported. A thorough literature review of midurethral tape erosions and, in particular, transobturator tape erosions was performed.
Results:
A 46-year-old woman with urodynamic stress incontinence underwent trans obturator tape insertion. Eight weeks later she developed vaginal discharge and was subsequently diagnosed with a left lateral vaginal wall tape erosion. The eroded section was excised under general anaesthetic. Two weeks later she presented with a large right sided groin abscess which required incision, drainage and debridement of necrotic areas of gracillis and adductor muscles. Short term results following trans obturator tape insertion report excellent efficacy rates (90-96% after 1 year), however there is a lack of long term data on safety and efficacy. Current literature on transobturator tape erosion is scanty and reported rates range from 1.9-7% depending on the tape inserted. Tape erosion commonly presents with vaginal discharge, bleeding or dyspareunia and several methods of management have been reported including conservative management, excision of the eroded section or removal of the entire tape.
Conclusions:
Groin abscess following tape erosion is a serious complication resulting in further surgery and months of morbidity for the woman. Prompt management of tape erosion is essential to minimise such complications and more data is required on the long term efficacy and safety of transobturator tapes.
Insights
Transobturator tape erosion can lead to serious groin abscesses, requiring surgical intervention and prolonged recovery. Prompt management of tape erosion is crucial to prevent severe complications and morbidity in women.
Area of Science:
- Urogynecology
- Surgical Complications
- Medical Device Safety
Background:
- Transobturator tape insertion is a common surgical treatment for urodynamic stress incontinence.
- While short-term efficacy is high, long-term safety data for these devices remain limited.
- Tape erosion is a known complication, with reported rates varying by device type.
Observation:
- A case of a 46-year-old woman who developed a groin abscess secondary to transobturator tape erosion is presented.
- The patient initially presented with vaginal discharge, diagnosed as vaginal wall tape erosion, followed by a severe groin abscess requiring extensive surgical debridement.
- Literature review indicates tape erosion commonly presents with vaginal discharge, bleeding, or dyspareunia.
Findings:
- Transobturator tape erosion is associated with significant morbidity, including severe infections like groin abscesses.
- Management options for tape erosion include conservative measures, partial excision, or complete tape removal.
- Current literature on transobturator tape erosion is limited, with reported incidence rates ranging from 1.9% to 7%.
Implications:
- Groin abscesses following tape erosion represent a serious complication demanding prompt and aggressive management.
- Further research is needed to fully understand the long-term safety and efficacy of transobturator tapes.
- Early recognition and intervention for tape erosion are essential to minimize patient morbidity and the need for further complex surgical procedures.
