Related Experiment Video
Updated: Dec 9, 2025
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
Delayed presentation of mons pubis abscess formation following MUS-case report and surgical video
Ariel Zilberlicht1, Debjyoti Karmakar2, Frida Carswell2
1Mercy Hospital for Women, Department of Urogynaecology, 163 Studley Road, Heidelberg, VIC, 3084, Australia. Arielzilberlicht@gmail.com.
Introduction And Hypothesis:
Mid-urethral sling (MUS) surgery for stress urinary incontinence (SUI) has relatively low complication rates. However, although rare, complications such as bladder wall, prepubic and thigh abscess occur. We present an unusual case of MUS vaginal mesh exposure followed by mons pubis abscess formation occurring 18 years postoperatively because of inadvertent prepubic insertion of the right arm. Our objectives were to raise awareness about such a rare complication and to describe the approach for sling removal.
Methods:
A 75-year-old woman presented with gradual swelling on the mons pubis followed by pain with a past history of MUS insertion. Examination revealed a palpable, tender, non-fluctuant mass, extending about 10-15 cm from mons pubis to the right labia. There was a 2 × 2-cm vaginal mesh exposure. Following imaging, an examination under anaesthesia was performed with vaginal exploration and complete removal of the right arm of the MUS and closure of the vagina.
Results:
Six months postoperatively, all surgical sites had healed well, and there was no recurrent SUI or persistent mesh exposure.
Conclusions:
Unusual long-term complications of MUS should be considered and recognized. Thorough evaluation is crucial for informed decision-making related to treatment strategies. The vaginal approach to mesh removal is safe and should be practised by experienced surgeons. Patients should be informed regarding the possibility of incontinence after sling removal.
