TOT mesh removal – Groin Pain

TOT mesh removal – Groin Pain

Mayo Clinic Patient
 
In 2022, Dr Miklos removed a TOT sling mesh arm from a patient’s right groin for chronic groin and medial thigh pain. This North Dakota patient had her TOT (transobturator tape) sling implanted in 2015 and suffered from post-operative pain and pelvic abscesses after the surgery. In 2017 she went to Mayo Clinic in Rochester MN where she had a transvaginal and a transabdominal approach to her TOT sling. The patient was quite pleased with her surgery at Mayo Clinic as it did relieve 80% of her pain but continued to suffer with right inguinal (groin) pain and medial thigh pain. Though Mayo Clinic attempted to remove all of the sling they were unable. She continued to suffer with right groin pain, medial thigh and right buttocks pain and when she returned to see the doctors at Mayo `Clinic, they explained that they did not feel comfortable taking her back to surgery.

She flew from North Dakota to see Dr Miklos in Atlanta Georgia to evaluate her condition.  Dr Miklos explained the best approach at a TOT sling removal, for inguinal and medial thigh pain, is through an inguinal (groin) incision.  An incision directly over the exit wound of the TOT sling is not only logical but pragmatic as it is exactly where the sling was placed during her 2015 surgery.  Dr Miklos performed the surgery without complication and was able to remove the remainder of the sling shown below measuring 6.5 cm.  Studies have shown that usually there is approximately 12-14 cm of mesh left inside the human body after TOT sling placement.  Dr Miklos was removing only the right side (6-7 cm) and he was able to remove 6.5 cm  The next morning she stated that her right buttocks pain was gone and was too numb to tell whether the groin pain was affected.

She will continue to recover and hopefully she will make a full recovery but only the patient and time will tell Dr Miklos if the mesh removal was a total success.