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Transcervical drainage of abdominal-pelvic abscess after laparoscopic sacrocolpopexy
E García García1,2, S de Miguel Manso3,4, J Gobernado Tejedor3,4
1Department of Obstetrics and Gynecology, Valladolid University Clinical Hospital, Av. Ramón y Cajal, 3, 47003, Valladolid, Spain. elenagargar@hotmail.com.
Introduction And Hypothesis:
Abdominopelvic abscess is a serious, but infrequent, postoperative complication of sacrocolpopexy, which a priori requires a second surgery to debride the affected tissue and dry out the infected mesh in addition to a prolonged broad-spectrum antibiotic therapy.
Methods:
We present two cases of post-surgical abdominopelvic abscesses, treated with conservative management using ultrasound-guided transcervical drainage and prolonged antibiotic therapy. Both patients underwent a favorable evolution without needing the removal of the mesh.
Conclusions:
Because of the search for new alternatives to avoid mesh removal and the comorbidity associated with a second surgery, transcervical drainage is a treatment to be considered in selected cases.
Insights
Abdominopelvic abscesses after sacrocolpopexy can be treated conservatively. Ultrasound-guided transcervical drainage and antibiotics offer a favorable outcome, potentially avoiding mesh removal.
Area of Science:
- Urogynecology
- Surgical Complications
- Medical Imaging
Background:
- Abdominopelvic abscess is a rare but severe complication following sacrocolpopexy.
- Traditional management often necessitates a second surgery for mesh debridement and removal.
- This approach carries significant risks and patient comorbidity.
Purpose of the Study:
- To evaluate the efficacy of conservative management for post-sacrocolpopexy abdominopelvic abscesses.
- To explore ultrasound-guided transcervical drainage as an alternative to surgical mesh removal.
- To assess the feasibility of avoiding mesh explantation in selected cases.
Main Methods:
- Presentation of two case studies of patients with post-surgical abdominopelvic abscesses.
- Conservative management involving ultrasound-guided transcervical drainage.
- Administration of prolonged broad-spectrum antibiotic therapy.
Main Results:
- Both patients demonstrated a favorable clinical evolution.
- Successful treatment was achieved without the need for mesh removal in either case.
- Transcervical drainage effectively managed the abscesses.
Conclusions:
- Ultrasound-guided transcervical drainage presents a viable conservative treatment option for selected abdominopelvic abscesses post-sacrocolpopexy.
- This approach may help avoid repeat surgeries and associated complications.
- It offers a promising alternative to mesh removal, preserving the implant.
