Abdominal sacral colpopexy resulting in a retained sponge. A case report

During abdominal sacral colpopexy, a procedure used to correct vaginal vault prolapse, the vaginal cuff must be elevated intraabdominally to facilitate suturing. The use of a vaginal sponge stick to elevate the cuff can result in foreign body complications.

A 70-year-old woman developed chronic pelvic pain and a vaginal discharge after undergoing abdominal sacral colpopexy. Radiographic films showed what appeared to be a retained surgical needle in the vaginal cuff. During an exploratory laparotomy to remove the foreign body, a fragment of the sponge used to elevate the vaginal cuff during abdominal sacral colpopexy was found to have been inadvertently incorporated into the apex of the vagina.

An end-to-end anastomotic sizer should be used to elevate the vaginal cuff during abdominal sacral colpopexy to reduce the risk of foreign body complications.