Case Report Obturator Nerve Injury: An Infrequent Complication of TOT Procedure S. Aydogmus, 1 S. Kelekci, 1 H. Aydogmus, 2 E. Ekmekci, 1 Y. Secil, 3 and S. Ture 4 1 Department of Obstetrics and Gynaecology, School of Medicine, ˙ Izmir Katip C ¸elebi University, Karabaglar, 35150 Izmir, Turkey 2 Department of Gynaecology and Obstetrics, Ataturk Research and Training Hospital, ˙ Izmir Katip C ¸ elebi University, Karabaglar, 35150 Izmir, Turkey 3 Department of Neurology, Ataturk Research and Training Hospital, ˙ Izmir Katip C ¸elebi University, Karabaglar, 35150 Izmir, Turkey 4 Department of Neurology, School of Medicine, ˙ Izmir Katip C ¸elebi University, Karabaglar, 35150 Izmir, Turkey Correspondence should be addressed to S. Aydogmus; serpilaydogmus@gmail.com Received 1 August 2014; Accepted 17 September 2014; Published 29 September 2014 Academic Editor: Lo¨ ıc Sentilhes Copyright © 2014 S. Aydogmus et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Transvaginal mid-urethral slings have become the most preferred surgical treatment option for female stress urinary incontinence. However, various complications have been reported for these operations occurring especially during penetration of the retropubic space. It can negatively afect patient’s quality of life. Early treatment increases the chance of complete normalization of the functions. In this case report we presented a case of obturator nerve damage that was diagnosed and treated at early stage afer TOT operation. 1. Introduction Stress urinary incontinence is a major public health problem afecting 20% of women and impairing quality of life. Due to their efcacy, safety, and ease of application, transvaginal midurethral slings have become the most preferred surgi- cal treatment option [1]. However, various complications have been reported of these operations occurring especially during the penetration of the retropubic space. Although the majority of complications are minor complications like bladder perforation, such as complications like vascular or bowel injury, nerve injury, hematoma development are possible complications that may be fatal. In order to reduce these complications, as an alternative method, transobturator tape (TOT) method has been developed by Delorme [2]. However, the TOT method is not a risk-free method and such complications like infection, erosion, and myositis have been reported in the literature [3]. It was reported that at 5% of cases have a leg pain and it is improved in one month with an analgesic therapy [4]. Nerve injury was reported in 0.7–0.9/1000 afer midurethral sling surgery [5]. In this case report, we presented a case of obturator nerve damage that was diagnosed and treated at early stage afer TOT operation. 2. Case Report Te patient was referred to us because of pain at the right leg, limitation, and inability to walk at the second postoperative day afer midurethral sling (Safyre, Promedon) surgery which was performed for stress urinary incontinence. When the patient was admitted to the hospital, it was noted that adduc- tion of the thigh was impaired. She was complaining about inability of adduction and paresthesias on the right thigh and she was not able to walk independently because of the loss of motor strength. Tese right adductor muscle symptoms were thought to be obturator nerve palsy. In magnetic res- onance imaging (MRI) at coronal section, tape (thin arrow) was observed passing very close to the obturator bundle (thick arrow) at the right obturator fossa (Figures 1(a)-1(b)). Tis was confrmed at axial section (Figures 1(c)-1(d)). In pelvic ultrasonography, we did not detect edema or hematoma around tape (Figure 1(e)). Methylprednisolone, 48 mg, niacin, 250 mg, and pyridoxine, 250 mg per day, were given to the patient. At postoperative day fve, cystoscopy was performed because symptoms were persisting. In cystoscopy, bladder and urethra were viewed intact. Te present TOT sling was removed and a new minisling was performed at the same session. Te patient’s symptoms dramatically declined Hindawi Publishing Corporation Case Reports in Obstetrics and Gynecology Volume 2014, Article ID 290382, 3 pages http://dx.doi.org/10.1155/2014/290382