Urogynecology: Case report obturator neuropathy after retropubic tension-free vaginal tape placement

BACKGROUND: We report a case of obturator neuropathy associated with retropubic midurethral sling. CASE: After retropubic tension-free vaginal tape (TVT) placement, a 36-year-old woman reported right inguinal region and thigh pain, both exacerbated with internal rotation and adduction. Neurologic examination was remarkable for two-fifths strength with right thigh adduction and an involuntary lateral drift of her right thigh with straight leg raise. Radiologic evaluation was unrevealing. With persistence of motor symptoms and pain, partial sling removal on the right was performed. Symptoms subsided postoperatively, and the patient ultimately recovered with no residual neurologic sequelae. CONCLUSION: Recognition of an atypical complication, obturator neuropathy, of retropubic TVT placement with prompt partial right sling removal on postoperative day 2 resulted in complete recovery of neurologic sequelae.