Posterior rectus abdominis sheath abscess after tension-free vaginal tape.
Summary of "Posterior rectus abdominis sheath abscess after tension-free vaginal tape."
Tension-free vaginal tape (TVT) is commonly used to treat stress urinary incontinence (SUI). TVT is known for its simplicity of use and successful outcomes with low morbidity [1]. However, complications can occur. We report an abscess posterior to the rectus muscle following TVT. A 46-year-old woman underwent TVT for SUI. On postoperative day (POD) 13, she presented with an abscess of the left suprapubic incision, which was treated with antibiotics and drainage. She represented on POD 22 with multiple pulmonary emboli and sepsis, and computed tomography (CT) revealed a multiloculated abdominal-wall fluid collection deep to the rectus muscle. The mesh was removed via vaginal incision. The rectus sheath abscess was accessed through a subfascial but extraperitoneal midline incision. The abdominal-wall wound was connected to the suprapubic wound. Whereas major infectious complications of TVT are rare, when they do occur, debridement, drainage, and removal of the mesh are imperative to prevent morbidity.
Affiliation
Department of Urology, Mayo Clinic, Rochester, MN, USA.
Journal Details
This article was published in the following journal.
Name: International urogynecology journal
ISSN: 1433-3023
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22430946
- DOI: http://dx.doi.org/10.1007/s00192-012-1723-1
Medical and Biotech [MESH] Definitions
Abdominal Muscles
Muscles forming the ABDOMINAL WALL including RECTUS ABDOMINIS, external and internal oblique muscles, transversus abdominis, and quadratus abdominis. (from Stedman, 25th ed)
Psoas Abscess
Abscess of the PSOAS MUSCLES resulting usually from disease of the lumbar vertebrae, with the pus descending into the muscle sheath. The infection is most commonly tuberculous or staphylococcal.
Oculomotor Muscles
The muscles that move the eye. Included in this group are the medial rectus, lateral rectus, superior rectus, inferior rectus, inferior oblique, superior oblique, musculus orbitalis, and levator palpebrae superioris.
Rectus Abdominis
A long flat muscle that extends along the whole length of both sides of the abdomen. It flexes the vertebral column, particularly the lumbar portion; it also tenses the anterior abdominal wall and assists in compressing the abdominal contents. It is frequently the site of hematomas. In reconstructive surgery it is often used for the creation of myocutaneous flaps. (From Gray's Anatomy, 30th American ed, p491)
Myelin Sheath
The lipid-rich sheath surrounding AXONS in both the central and peripheral nervous systems. The myelin sheath is an electrical insulator and allows faster and more energetically efficient conduction of impulses. The sheath is formed by the cell membranes of glial cells (SCHWANN CELLS in the peripheral and OLIGODENDROGLIA in the central nervous system). Deterioration of the sheath in DEMYELINATING DISEASES is a serious clinical problem.
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