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Complex Sacral Abscess 8 Years After Abdominal Sacral Colpopexy

Collins, Sarah A. MD; Tulikangas, Paul K. MD; LaSala, Christine A. MD; Lind, Lawrence R. MD

doi: 10.1097/AOG.0b013e3182234e7c
Case Reports
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BACKGROUND: Sacral colpopexy is an effective, durable repair for women with apical vaginal or uterovaginal prolapse. There are few reports of serious complications diagnosed in the remote postoperative period.

CASE: A 74-year-old woman presented 8 years after undergoing posthysterectomy abdominal sacral colpopexy using polypropylene mesh. Posterior vaginal mesh erosion had been diagnosed several months before presentation. She suffered severe infectious complications including an infected thrombus in the inferior vena cava, sacral osteomyelitis, and a complex abscess with presacral and epidural components. Surgical exploration revealed an abscess cavity surrounding the mesh.

CONCLUSION: Although minor complications commonly occur after sacral colpopexy using abdominal mesh, serious and rare postoperative infectious complications may occur years postoperatively.

A septic 74-year-old woman presents with a presacral abscess, sacral osteomyelitis, epidural abscess, and infected inferior vena cava embolus 8 years after sacral colpopexy.

From Hartford Hospital/University of Connecticut Health Center, Division of Urogynecology, Department of Obstetrics and Gynecology, Hartford, Connecticut; and North Shore Long Island Jewish Health System, Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, Great Neck, New York.

Corresponding author: Sarah A. Collins, MD, 85 Seymour St., Suite 525, Hartford, CT 06106; e-mail: scollins@harthosp.org.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists