title: Iatrogenic Bladder Diverticulum 11 Years After Sacrospinous Ligament Fixation for Apical Prolapse.
abstract: In this case, we describe a bladder diverticulum due to apical vaginal suspension to the sacrospinous ligament presenting 11 years after surgery. This case report explores her signs and symptoms, diagnostic work-up, surgical intervention, and postoperative course.
  
  
  
  A 71-year-old G2P2 presented with symptoms of urinary urgency. Work-up including cystoscopy and retrograde fistulogram revealed a bladder diverticulum extending to the level of the sacrospinous ligament. Her surgical history was significant for a sacrospinous ligament fixation 11 years before her symptoms. The iatrogenic bladder diverticulum was removed via robotic-assisted laparoscopic excision. Her postoperative course was benign beyond a urinary tract infection. Her urgency symptoms resolved after treatment.
  
  
  
  Iatrogenic injuries can present distant from initial surgery. Permanent foreign material, including suture, may increase the risk of complications. A high level of suspicion is necessary to diagnose complications given the subtle presentation.
authors: From the *Departments of Female Pelvic Medicine and Reconstructive Surgery, †Obstetrics and Gynecology, and ‡Urology, Baylor Scott and White Health, Temple, TX.
authors: Laura Faye
authors: LF
authors: Gephart
authors: Anthony
authors: A
authors: Lewis
authors: Emily
authors: E
authors: Wu
authors: Erin
authors: E
authors: Bird
authors: Kristofer
authors: K
authors: Wagner
authors: Thomas J
authors: TJ
authors: Kuehl
authors: Wilma
authors: W
authors: Larsen
mesh_terms: D000368:Aged; D004240:Diverticulum / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007049:Iatrogenic Disease; D008279:Magnetic Resonance Imaging; D056887:Pelvic Organ Prolapse / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D065287:Robotic Surgical Procedures; D013537:Sutures / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery