Small-pore polypropylene slings: still out there

We report on a case of a suburethral erosion of transobturator tape tracking into the right thigh with abscess formation 20 months from surgery resulting in necrotizing fasciitis. A 64-year-old woman presented with new onset of severe right thigh pain. Physical exam was concerning for a right thigh abscess and she was admitted to general surgery for evaluation. Gynecology was consulted secondary to a complaint of foul vaginal discharge. The patient was noted to have a vaginal mass on the anterior vaginal wall. A computed tomography scan showed a large right medial thigh abscess. The patient was taken for emergency exploratory surgery where an ObTape® (Mentor, Santa Barbara, CA, USA) TOT was found eroding through the anterior vaginal wall, extending into the thigh abscess. During removal of the ObTape® from her thigh, the entire gracilis muscle was removed due to necrotizing fasciitis and extensive tissue debridement was performed. A wound vac was placed and the patient had an uneventful recovery.