Pre-ramus passage of inside–out transobturator sling

International Urogynecology Journal, 10/18/2010

Roth TM – Groin pain after transobturator tape is not uncommon. Differential diagnosis and treatment strategies are becoming elaborated in the literature. A patient presented with partial improvement in her stress incontinence and persistent groin and vulvar discomfort for 3 months after “inside–out” transobturator tape. The sling was removed secondary to malposition anterior to the inferior pubic ramus, i.e., a trans–vulvar passage. Her vulvar and groin complaints resolved. Recommendations are made to facilitate the “inside to out” transobturator dissection and trocar passage to prevent this complication.

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