Obturator and thigh abscess after transobturator tape implantation for stress urinary incontinence

We report a case of obturator and thigh abscess 2 years after transobturator tape implantation (TVT-O) for stress urinary incontinence. Fifteen months after sling implantation repeated incisions and drainages of multiple recurrent thigh abscesses were performed. The source of infection, an eroded TVT-O, was only identified on readmission 9 months later when vaginal discharge was reported by the patient. Magnetic resonance imaging was performed because of tenderness and pain in the leg which revealed a large obturator and thigh abscess. The TVT-O was completely excised and the abscesses drained. Further follow-up was uneventful. This new technique of sling placement via the obturator route may be associated with novel infectious complications. Symptoms and signs as well as imaging modalities and conservative versus surgical management are discussed and the literature reviewed.