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Rectal mesh erosion after robotic sacrocolpopexy
Cori-Ann Hirai1, Justin C Bohrer, Matthew Ruel
1Department of Obstetrics & Gynecology, University of Hawaii, Honolulu, HI, USA. cmhirai@gmail.com
Abstract:
We report an unusual case of rectal mesh erosion presenting 16 months after robotic sacrocolpopexy. The patient initially underwent a robotic sacrocolpopexy, lysis of adhesions, midurethral sling, and posterior colporrhaphy for symptomatic grade 2 pelvic organ prolapse and urodynamic stress incontinence. Her postoperative recovery was uneventful. Sixteen months later, an anterior 2 × 2-cm rectal mesh erosion was noted on the colonoscopy performed when she presented with hematochezia.
Insights
A rare complication of robotic sacrocolpopexy, rectal mesh erosion, occurred 16 months post-surgery. This case highlights a delayed presentation of mesh erosion after pelvic reconstructive surgery.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Gastroenterology
Background:
- Pelvic organ prolapse and stress urinary incontinence are common conditions in women.
- Robotic sacrocolpopexy is a surgical option for pelvic reconstructive surgery.
- Mesh materials are frequently used in pelvic reconstructive procedures.
Observation:
- A patient presented with hematochezia 16 months after undergoing robotic sacrocolpopexy, lysis of adhesions, midurethral sling, and posterior colporrhaphy.
- The patient had an initially uneventful postoperative recovery from the initial surgery.
- A 2x2 cm anterior rectal mesh erosion was identified during colonoscopy.
Findings:
- Rectal mesh erosion is an uncommon but serious complication following robotic sacrocolpopexy.
- Delayed presentation of mesh erosion, up to 16 months post-surgery, is possible.
- Hematochezia can be a presenting symptom of rectal mesh erosion.
Implications:
- This case underscores the importance of vigilance for delayed mesh complications after pelvic reconstructive surgery.
- Further research may be needed to elucidate risk factors and optimal management strategies for rectal mesh erosion.
- Enhanced patient counseling regarding potential long-term mesh-related complications is warranted.
