One hundred and forty‐nine women received a suburethral woven polypropylene mesh insertion for urodynamic stress incontinence. Eleven patients (7.5%) presented between 4 and 17 months after surgery (mean 10 months) with symptoms of retropubic infection. Ten patients required surgical exploration, drainage of the collection and removal of the tape either unilaterally (six) or bilaterally (four). Bacterial cultures were negative in nine women. Following removal of the tape, eight patients reported residual incontinence, either stress leakage (five) or de novo urge incontinence (three). Multifilament polypropylene meshes appear to be more at risk of infection, usually requiring sling removal, which may be related to pore size of the mesh. Our data reinforce the importance of proper evaluation of new surgical procedures by rigorously designed randomised trials with adequate follow up to identify rare but potentially serious complications.
A 39-year-old patient was evaluated for pelvic pain and infection following a surgical abortion performed via aspiration curettage. A pelvic computed tomography (CT) revealed an invagination of fat in the uterine wall accompanied by an abscess in the rectouterine pouch. Laparoscopic exploration revealed an incarcerated cecal appendix within the myometrium with necrosis of the appendiceal base as the culprit. A posteriori, CT multiplanar reconstruction allowed identification of the incarcerated appendix within the myometrium. To our knowledge, this CT description is the only case described in the literature.
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