Case – Recurrent abscess and vaginal-thigh fistula from a transobturator mesh tape after COVID-19 vaccination

We present the case of a 55-year-old female who had an uncomplicated TOT procedure in 2006 by a senior general gynecologist for SUI.Her medical history included a myocardial infarction secondary to ventricular fibrillation, chronic obstructive pulmonary disease, dyslipidemia and hypertension.Additional surgical history included a recent right tibial open reduction and internal fixation from a fall.She had not been sexually active for several years and denied any intravenous drug use.She had an allergy to sulfa drugs.Four days after her second COVID-19 mRNA vaccination, the patient presented to the community emergency department with a four-day history of pain to the right upper thigh, foulsmelling vaginal discharge and new vaginal bleeding.She also reported a fall and a bruise to the surrounding right upper thigh one month prior, but no penetrating injury.General surgery was consulted and examination was notable for erythema and tenderness to the right medial upper thigh, with no palpable mass or fluctuance, and ongoing foul vaginal discharge.She remained afebrile and vitally stable, and motor and sensory function remained intact.CT revealed a suspected abscess with gas along the right adductor magnus muscle measuring 7 cm x 12 cm, KEY MESSAGES• Long-term complications after a transobturator tape procedure can include recurrent thigh abscess and vaginal-thigh fistula formation.Surgical excision is required for definitive management.• Further research is needed to investigate the association of COVID-19 mRNA vaccination and development of novel abscess CUAJ -Resident's Room Lu et al Long-term complications after a transobturator tape 2