Sacral osteomyelitis: an unusual complication of abdominal sacral colpopexy.
BACKGROUND
Abdominal sacral colpopexy using permanent mesh is an established technique for repair of vaginal vault prolapse. Infection is not a frequent complication. We report two cases of lumbosacral osteomyelitis treated with intravenous antibiotics without mesh removal.


METHODS
The first patient had known advanced degenerative arthritis. Unremitting severe low back pain 5 years after abdominal sacral colpopexy prompted magnetic resonance imaging (MRI), revealing osteomyelitis and diskitis. The second patient developed symptoms 2 months postoperatively, and MRI indicated osteomyelitis with epidural abscess. Both patients received intravenous antibiotics, and neither required surgical debridement or mesh removal.


CONCLUSIONS
Osteomyelitis can present remote from the operation and can be difficult to diagnose. Protracted parenteral antibiotic therapy can be definitive treatment without mesh removal.
Weidner
A C
AC
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Cundiff
G W
GW
Harris
R L
RL
Addison
W A
WA
D000368:Aged; D000900:Anti-Bacterial Agents; D003127:Colposcopy; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D011093:Polyethylene Terephthalates; D012447:Sacrum; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology; D013536:Suture Techniques; D014596:Uterine Prolapse / Q000601:surgery
D000900:Anti-Bacterial Agents; D011093:Polyethylene Terephthalates; C025539:Lavsan