Abstract:

Sacrocolpopexy has been applied in clinic for many years, but recently the complications associated with mesh were reported frequently. Spondylodiscitis is a rare complication of sacrocolpopexy. The clinical management is difficult and causes great pain to patients. A case of spondylodiscitis was reported 4 months after vaginal hysterectomy combined with laparoscopic sacrocolpopexy. The patient developed persistent pain of the lumbosacral portion,and the pain was worse and restricted the mobility. Gynecological examination indicated vaginal stump mucosal defects,and no obvious abnormalities were observed. Pelvic and spine MRI examination revealed presacral infection of L5-S2. Exploratory laparotomy was performed and partial infection of the mesh was found. The infected mesh was removed. Followed by the surgery,the patient was cured via antibiotics, peritoneal lavage and drainage and local application of estrogen cream. After 5 years of follow-up,no related complications and recurrence of vaginal prolapse were found. The mechanism,clinical evaluation,management and prevention of the complications were reviewed in order to improve clinicians′ understanding of the complication.

Key words: Pelvic organ prolapse, Sacrocolpopexy, Mesh, Complications, Spondylodiscitis, Case reports