Lumbosacral osteomyelitis after robot-assisted total laparoscopic hysterectomy and sacral colpopexy.
We report on the transabdominal resection of infected lumbosacral bone, synthetic mesh, and sinus tract following sacral colpopexy. A 45-year-old nulliparous patient who had undergone transvaginal mesh followed by robot-assisted sacral colpopexy presented with increasing back pain and foul-smelling vaginal drainage. An epidural abscess required surgical intervention, including diskectomy, sacral debridement, and mesh removal to drain the abscess and vaginal sinus tract. Recognized complications of open prolapse procedures also manifest following minimally invasive approaches. Osteomyelitis of the sacral promontory following sacral colpopexy may require gynecologic and neurosurgical management.
Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH 44195, USA. mufflyt@ccf.org
Tyler M
TM
Muffly
Gouri B
GB
Diwadkar
Marie Fidela R
MF
Paraiso
D003127:Colposcopy / Q000009:adverse effects* / Q000379:methods; D003646:Debridement; D017586:Diskectomy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D056887:Pelvic Organ Prolapse / Q000601:surgery; D012307:Risk Factors; D012371:Robotics; D012447:Sacrum / Q000382:microbiology* / Q000601:surgery; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013526:Surgical Mesh / Q000382:microbiology