Advertisement

Topics

Necrotizing postsurgical infection complicating midurethral sling procedure with unrecognized cystotomy.

06:00 EDT 1st May 2012 | BioPortfolio

Summary of "Necrotizing postsurgical infection complicating midurethral sling procedure with unrecognized cystotomy."


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.

Affiliation

From the Departments of *Obstetrics and Gynecology, and †Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, IA.

Journal Details

This article was published in the following journal.

Name: Female pelvic medicine & reconstructive surgery
ISSN: 2151-8378
Pages: 183-5

Links

DeepDyve research library

PubMed Articles [9937 Associated PubMed Articles listed on BioPortfolio]

Outcomes of three sling procedures at the time of abdominal sacral colpopexy.

A sling at time of sacral colpopexy (SCP) for apical pelvic organ prolapse (POP) is valuable in the treatment of overt, urodynamic, and occult stress urinary incontinence (SUI). As there is no current...

Are patients willing to trade cure rate against less pain? Patients' preferences for single incision midurethral sling or transobturator standard midurethral sling.

To quantify to what extent patients are willing to trade their chance of cure of stress urinary incontinence (SUI) against less postoperative groin pain. Randomized, controlled trials show less postop...

Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision.

The objectives of this study were to characterize outcomes in women undergoing surgical revision of a midurethral sling and characterize factors associated with satisfaction of revision.

Fatal Injury of the Small Intestine during Retropubic Sling Placement.

We describe a case of injury of the small intestine in a patient who underwent placement of Align R retropubic urethral support system (BARD). Absence of characteristic symptoms of the bowel injury an...

Re: Urethral bulking for recurrent urinary stress incontinence after midurethral sling failure.

Clinical Trials [3614 Associated Clinical Trials listed on BioPortfolio]

A Comparison of the Retropubic (TVT) With the Transobturator Sling Operation in the Treatment of Female Stress Urinary Incontinence or Stress Dominated Mixed Urinary Incontinence

The midurethral tension-free vaginal tape (a macroporous polypropylene mesh) procedure is a well established technique for treating female stress urinary incontinence in patients with (hyp...

Mid-Urethral Sling Tensioning Trial

Prospective randomized clinical trial comparing two methods of intra-operative tensioning of retropubic midurethral slings for stress urinary incontinence. Primary outcome is rate of abnor...

The SLIM Study: Sling and Botox® Injection for Mixed Urinary Incontinence

This double-blind randomized controlled trial seeks to find a better treatment for women with mixed urinary incontinence (both stress and urgency incontinence). The primary aim is to deter...

Impact of Liposomal Bupivacaine Administered Following Placement of a Transobturator Suburethral Sling

Liposomal bupivacaine or placebo will be administered at the end of a transobturator midurethral sling to determine if there is a difference in a patient's perceived postoperative pain.

Polyacrylamide Injection in Patients Ineligible for Surgery

Transurethral injection using polyacrylamide hydrogel (Bulkamid®, Contura A/S, Denmark) is an established treatment for stress urinary incontinence. The rates of women reporting improveme...

Medical and Biotech [MESH] Definitions

A fulminating bacterial infection of the deep layers of the skin and FASCIA. It can be caused by many different organisms, with STREPTOCOCCUS PYOGENES being the most common.

Inflammation of the fascia. There are three major types: 1, Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orange-peel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2, Necrotizing fasciitis (FASCIITIS, NECROTIZING), a serious fulminating infection (usually by a beta hemolytic streptococcus) causing extensive necrosis of superficial fascia; 3, Nodular/Pseudosarcomatous /Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma.

Widespread necrotizing angiitis with granulomas. Pulmonary involvement is frequent. Asthma or other respiratory infection may precede evidence of vasculitis. Eosinophilia and lung involvement differentiate this disease from POLYARTERITIS NODOSA.

A loss of mucous substance of the mouth showing local excavation of the surface, resulting from the sloughing of inflammatory necrotic tissue. It is the result of a variety of causes, e.g., denture irritation, aphthous stomatitis (STOMATITIS, APHTHOUS); NOMA; necrotizing gingivitis (GINGIVITIS, NECROTIZING ULCERATIVE); TOOTHBRUSHING; and various irritants. (From Jablonski, Dictionary of Dentistry, 1992, p842)

A set of surgical procedures performed to establish sufficient outflow to the systemic circulation in individuals with univentricular congenital heart malformations, such as HYPOPLASTIC LEFT HEART SYNDROME, and MITRAL VALVE atresia, associated with systemic outflow obstruction. Follow-on surgeries may be performed and consist of a HEMI-FONTAN PROCEDURE as the stage 2 Norwood procedure and a FONTAN PROCEDURE as the stage 3 Norwood procedure.

Quick Search
Advertisement
 


DeepDyve research library

Relevant Topics

Infectious-diseases
Antiretroviral Therapy Clostridium Difficile Ebola HIV & AIDS Infectious Diseases Influenza Malaria Measles Sepsis Swine Flu Tropical Medicine Tuberculosis Infectious diseases are caused by pathogenic...

Stress
Stress is caused by your perception of situations around you and then the reaction of your body to them. The automatic stress response to unexpected events is known as 'fight or flight'. Discovered by Walter Cannon in 1932, it is the release of h...


Searches Linking to this Article