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Late onset of isolated myositis following a Transobturator (TOT) mid-urethral sling (MUS) is a rare post-operative complication.
A 38-year-old gravida 3 para 3003 with a long standing history of mixed urinary incontinence, Stage 2 anterior prolapse, dysmenorrhea, and abnormal uterine bleeding underwent a hysteroscopy with dilation and curettage, levonorgestrel intrauterine device insertion, anterior colporrhaphy, MUS insertion using the TOT approach and cystoscopy. Eight weeks post-op, she presented to the emergency room with right inguinal and low back pain, difficulty ambulating, and fevers. Magnetic Resonance Imaging (MRI) of the right hip revealed inflammatory fluid collection within the adductor brevis with posterior extension to the right femur concerning for myositis. She was admitted to the hospital for 12 days on broad spectrum antibiotics with clinical improvement and discharged with 2 weeks of outpatient antibiotics. Follow up MRI showed near complete resolution of fluid collection in right adductor muscle. Patient consent was obtained for this case report.
We present a rare case of late-onset isolated myositis following TOT MUS. Conservative treatment with antibiotics with a multidisciplinary team is a reasonable approach and can lead to resolution of patient symptoms without need for repeated surgical intervention.
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Lee B, Mahmoud M. Late-onset Isolated Myositis Following Transobturator Mid-Urethral Sling: A Case Report. Advances in Clinical Medical Research and Healthcare Delivery. 2023; 3(2). doi: 10.53785/2769-2779.1151.