Incidence of pubic osteomyelitis after bladder neck suspension using bone anchors

Goldberg, Roger P.; Tchetgen, Marie Blanche; Sand, Peter K.; Koduri, Sumana; Rackley, Raymond R.; Appell, Rodney A.; Culligan, Patrick J.

doi:10.1016/j.urology.2003.11.013

Cited by 32 publications

(17 citation statements)

References 20 publications

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“…We acknowledge that fixation with bone anchors raises concern for related osseous complications. Nonetheless, our experience and that previously reported would suggest that such complications are an extremely rare occurrence [13].…”

Section: Discussionsupporting

confidence: 52%

Transvaginal bone-anchored sling for the treatment of female stress urinary incontinence: effect of Valsalva leak point pressure and prior pelvic surgery on outcomes

et al. 2008

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The effect of lower Valsalva leak point pressure (VLPP) and previous pelvic surgery on outcomes following sling surgery is controversial. We assessed outcomes following bone-anchored sling (BAS) placement in patients with intrinsic sphincteric deficiency (ISD) and previous pelvic surgery. A retrospective review of 149 patients undergoing BAS placement was performed. Patients were stratified by VLPP (> or =60, <60, and <30) and by history of previous anti-incontinence/pelvic floor surgery. Outcomes were assessed using a questionnaire comprising validated urogenital distress inventory (UDI)-6, incontinence impact questionnaire (IIQ)-7 questionnaires and additional items addressing satisfaction. In comparing the three VLPP cohorts, the percentage of patients reporting incontinence episodes of <1/week (64%, 68%, and 63%, respectively) and postoperative UDI/IIQ questionnaire scores were similar (p > 0.2, all comparisons). Lower rates of patients achieving <1 episode of incontinence per week (50%; p = 0.07) and worse UDI/IIQ scores (p = 0.02) were associated with patients with > or =2 prior surgeries. Whereas results are similar following BAS in patients with or without varying degrees of ISD, worse outcomes are associated with prior surgery.

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Section: Discussionsupporting

confidence: 52%

Transvaginal bone-anchored sling for the treatment of female stress urinary incontinence: effect of Valsalva leak point pressure and prior pelvic surgery on outcomes

et al. 2008

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“…The continued presence of a foreign body presents another risk factor for infection because titanium and monofilament suture materials are placed into and around the bone. Finally, the possibility of transvaginal bacterial contamination remains an opportunity for infection of the materials [19], although osteomyelitis has been reported as a complication of both transabdominal and transvaginal approaches for bone anchors.…”

Section: Discussionmentioning

confidence: 99%

“…Through July 2000, Rackley et al [17] reviewed approximately 30 reports involving more than 1,000 patients to estimate the prevalence of bone-anchor-related infections in female pelvic reconstructive procedures as 0.6%. More recently, Goldberg et al [19] reported three cases of pubic osteomyelitis among 225 patients after bone anchoring procedures for stress incontinence.…”

Section: Discussionmentioning

confidence: 99%

“…The role of imaging in osteomyelitis is to confirm the presence of active infection and delineate the extent of debridement necessary to remove necrotic bone and soft tissue completely [19]. Plain anteroposterior and pelvic outlet radiography, CT, MRI, and bone scans detect radiographic changes that range from minimal findings initially to irregular, localized bone destruction in osteomyelitis [17].…”

Section: Discussionmentioning

confidence: 99%

“…CT will reveal soft tissue involvement more reliably than bony involvement. CT-guided needle aspiration or biopsy may play a useful role in establishing the diagnosis and initiating treatment [19]. Fluoroscopy can be utilized to help localize the anchor intraoperatively [20].…”

Section: Discussionmentioning

confidence: 99%

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Actinomyces meyeri osteomyelitis of the symphysis pubis following pubovaginal sling

et al. 2007

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Previous reports of pubic osteomyelitis associated with bone anchors describe symptoms presenting 10 days to 12 months postoperatively with typical pathogens including Streptococcus, Staphylococcus, Citrobacter, and Pseudomonas (Fitzgerald et al., Int Urogynecol J 10:346-348, 1999 Enzler et al., J Bone Jt Surg Am 81-A(12):1736-1740, 1999; Graham and Dmochowski, J Urol 168:2055-2058, 2004; Fialkow et al., Urology 64(6):1127-1132, 2004; Matkov et al., J Urol 160(4):1427, 1998). This case illustrates the potential for protracted symptoms and delayed diagnosis of pubic osteomyelitis with the fastidious pathogen of Actinomyces meyeri.

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Bladder Neck Slings for Stress Urinary Incontinence

Westney¹

2007

Female Urology

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Incidence of pubic osteomyelitis after bladder neck suspension using bone anchors

Cited by 32 publications

References 20 publications

Transvaginal bone-anchored sling for the treatment of female stress urinary incontinence: effect of Valsalva leak point pressure and prior pelvic surgery on outcomes

Transvaginal bone-anchored sling for the treatment of female stress urinary incontinence: effect of Valsalva leak point pressure and prior pelvic surgery on outcomes

Actinomyces meyeri osteomyelitis of the symphysis pubis following pubovaginal sling

Bladder Neck Slings for Stress Urinary Incontinence

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