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Abdominal sacral colpopexy mesh erosion resulting in a sinus tract formation and sacral abscess
Stuart R Hart1, Edward B Weiser
1Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia, USA. shart@gwinnett-gyn.com
Background:
Complications associated with the use of synthetic mesh during an abdominal sacral colpopexy procedure include mesh infection and erosion into the vaginal vault and sacral osteomyelitis.
Case:
This case report describes the management of an abdominal sacral colpopexy procedure that was complicated by postoperative vaginal mesh erosion, formation of a fistulous tract from the vaginal apex to the sacrum, and development of diskitis, osteomyelitis, and a sacral abscess.
Conclusion:
Treatment of a vaginal mesh erosion complicated by the formation of a sinus tract after abdominal sacral colpopexy should include extensive sinus tract resection in addition to complete mesh removal.
Insights
Abdominal sacral colpopexy using synthetic mesh can lead to complications like vaginal mesh erosion. Complete mesh and sinus tract removal is crucial for treating these complex cases.
Area of Science:
- Urogynecology
- Pelvic reconstructive surgery
- Surgical complications
Background:
- Synthetic mesh use in abdominal sacral colpopexy can cause complications.
- Potential complications include mesh infection, vaginal vault erosion, and sacral osteomyelitis.
Observation:
- This case report details managing a patient with abdominal sacral colpopexy.
- Complications included postoperative vaginal mesh erosion, a fistula to the sacrum, diskitis, osteomyelitis, and a sacral abscess.
Findings:
- Vaginal mesh erosion following abdominal sacral colpopexy can lead to complex fistulous tracts.
- Associated infections can include diskitis, osteomyelitis, and abscess formation.
Implications:
- Effective treatment requires complete mesh removal.
- Extensive sinus tract resection is essential for managing these erosions and fistulas.
