Journal article
Necrotizing postsurgical infection complicating midurethral sling procedure with unrecognized cystotomy.
Female pelvic medicine & reconstructive surgery, Vol.18(3), pp.183-185
05/01/2012
DOI: 10.1097/SPV.0b013e3182544dee
Abstract
A 39-year-old woman with stress urinary incontinence underwent a retropubic midurethral sling procedure. On postoperative day 1, she presented with persistent abdominal pain and fever. A computed tomographic scan showed subcutaneous lower abdominal wall edema and gas above the fascia suggesting a necrotizing soft tissue infection. She was surgically debrided twice, which included removal of the mesh sling on postoperative day 4. Cystoscopy suggested unrecognized bladder perforation had occurred during the initial procedure, and record rerevealed untreated bacteriuria before sling placement. The patient required wound vacuum therapy and a later secondary wound closure procedure. Six months after the initial surgery, she was reevaluated for stress urinary incontinence and underwent a transobturator midurethral sling procedure with resolution of these symptoms. Necrotizing postsurgical infection is a rarely described complication of midurethral slings. Treatment for this potentially life-threatening complication includes aggressive surgical debridement, administration of broad-spectrum antibiotic, removal of infected implants, and supportive therapy. Unrecognized bladder injury and preoperative bacteriuria are discussed as potential risk factors for postsling necrotizing infection.
Details
- Title: Subtitle
- Necrotizing postsurgical infection complicating midurethral sling procedure with unrecognized cystotomy.
- Creators
- Amandeep Singh MahalCatherine S. Bradley - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Female pelvic medicine & reconstructive surgery, Vol.18(3), pp.183-185
- DOI
- 10.1097/SPV.0b013e3182544dee
- ISSN
- 2151-8378
- Language
- English
- Date published
- 05/01/2012
- Academic Unit
- Urology; Epidemiology; Obstetrics and Gynecology
- Record Identifier
- 9983557410702771
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