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Sacral Osteomyelitis After Robotic Sacrocolpopexy

Feng, Tom S. MD; Thum, Dennis J. MD; Anger, Jennifer T. MD, MPH; Eilber, Karyn S. MD

Female Pelvic Medicine & Reconstructive Surgery: January/February 2016 - Volume 22 - Issue 1 - p e6–e7
doi: 10.1097/SPV.0000000000000219
Case Reports
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Background Robotic-assisted abdominal sacrocolpopexy (RASC) is an effective procedure for the surgical treatment of vaginal vault prolapse associated with a rare, but serious, risk of sacral osteomyelitis.

Case We report a case of Bacteroides fragilis sacral osteomyelitis after RASC that presented only as back pain. Treatment included intravenous antibiotics and abdominal exploration with removal of sacral mesh.

Conclusions Sacral osteomyelitis is a rare complication following RASC and may present only as back pain without constitutional symptoms. Intravenous antibiotics and surgical excision of sacral mesh are routinely performed, but preservation of vaginal mesh is a viable option. The clinician should have a high index of suspicion for osteomyelitis in any patient who presents with back pain after RASC, regardless of absence of other presenting symptoms.

We report a case of sacral osteomyelitis after robotic-assisted abdominal sacrocolpopexy that required intravenous antibiotics as well as removal of infected mesh.

From the Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Reprints: Karyn S. Eilber, MD, 99 North La Cienega Boulevard Suite 307 Beverly Hills, CA 90211. E-mail: karyn.eilber@cshs.org.

K.S.E. is a consultant and investigator for American Medical Systems and an investigator for Boston Scientific. J.T.A. is an investigator for American Medical Systems, Boston Scientific, and Cook Myosite, Incorporated.

The other authors have declared they have no conflicts of interest.

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