PUZZLING PELVIC PAIN AFTER TRANSOBTURATOR TAPE (TOT)OUTSIDE-INSIDE SURGERY: A CASE REPORT.

This paper reports about persistent pain, arising 3 months postoperatively, after placement of the Safyre-t™ transobturator device in a 44-year-old, severely obese woman. All diagnostic investigations were performed and a bilateral coxarthrosis with suspect of an ileopettinea bursitis was diagnosed. Even though we were not convinced that device removal would lead to a resolution of the patient’s problems, following the patient’s adamant wishes, part of the device was removed maintaining the continence. The pain however, migrated contra-laterally. The remaining part of the sling was removed shortly after. The patient returned to being incontinent. To date she is still incontinent and in pain. Now we know that it depended on a concomitant rheumatic pathology and that it did not depend on anti-incontinence surgery. At the present time, she is undergoing pelvic floor rehabilitation for incontinence and ultrasound therapy for inguinal and hip pain with success. From our experience, we know that postoperative pain is an important complication after the placing of a transobturator tape, though sometimes the cause is not clear and the solution not easy. It is very worrying for us that pain is often blamed on the surgery where in some cases it is not actually the cause.