title: Sacral Osteomyelitis After Robotic Sacrocolpopexy.
abstract: BACKGROUND
  Robotic-assisted abdominal sacrocolpopexy (RASC) is an effective procedure for the surgical treatment of vaginal vault prolapse associated with a rare, but serious, risk of sacral osteomyelitis.
  
  
  METHODS
  We report a case of Bacteroides fragilis sacral osteomyelitis after RASC that presented only as back pain. Treatment included intravenous antibiotics and abdominal exploration with removal of sacral mesh.
  
  
  CONCLUSIONS
  Sacral osteomyelitis is a rare complication following RASC and may present only as back pain without constitutional symptoms. Intravenous antibiotics and surgical excision of sacral mesh are routinely performed, but preservation of vaginal mesh is a viable option. The clinician should have a high index of suspicion for osteomyelitis in any patient who presents with back pain after RASC, regardless of absence of other presenting symptoms.
authors.affiliation: From the Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Tom S
authors.initials: TS
authors.lastname: Feng
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Thum
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Anger
authors.forename: Karyn S
authors.initials: KS
authors.lastname: Eilber
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001416:Back Pain / Q000209:etiology; D001442:Bacteroides Infections / Q000188:drug therapy; D001441:Bacteroides fragilis; D003127:Colposcopy / Q000379:methods; D004866:Equipment Contamination; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000209:etiology*; D056887:Pelvic Organ Prolapse / Q000601:surgery; D012086:Reoperation; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D012447:Sacrum / Q000601:surgery; D013122:Spinal Diseases / Q000209:etiology*; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents