Pyogenic spondylodiscitis associated with sacral colpopexy and rectopexy: report of two cases and evaluation of the literature

Abstract

Pyogenic spondylodiscitis includes a spectrum of spinal infections such as discitis, osteomyelitis, epidural abscess, meningitis, subdural empyema, and spinal cord abscess. This is a rare complication of sacral colpopexy, but can lead to devastating consequences for the patient. We present two cases of pyogenic spondylodiscitis following sacral colpopexy. In addition, we discuss 26 cases of pyogenic spondylodiscitis reported in the literature from 1957 to 2012. Techniques to decrease rates of infection include proper identification of the S1 vertebra, awareness of the suture placement depth at the level of the sacrum and at the vagina, and early treatment of post-operative urinary tract and vaginal infections. Awareness of symptoms, timely diagnosis and multidisciplinary approach to management is essential in preventing long-term complications.

Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 patients

“…Perioperative complications of Clavien-Dindo grade III or more occurred rarely in our cohort, and conversion to laparotomy was not necessary in any of our patients, which is in accordance with previously reported results with other techniques. However, lesions of the superior hypogastric plexus, the right hypogastric nerve and spondylodiscitis are known complications of sacral fixation, and numerous cases have been described in the literature [21]. The advantage of our technique is that it avoids dissection at the level of the promontory and the associated risks of neurological, vascular, ureteral or other tissue lesions, which are commonly reported in obese women.…”

Perioperative outcomes and prospective patient reported outcome measures for transvaginal mesh surgery

“…Abdominal surgery is not without significant complications including greater perioperative morbidity with a higher economic burden. Rare but devastating complications such as pyogenic spondylodiscitis and bowel obstruction have been reported following abdominal sacrocolpopexy [3].…”

Spondylodiscitis after rectopexy: diagnostic of a rare complication

“…One study showed that polyester strips were responsible for a smaller number of erosions, while polypropylene strips were less associated with septic complications. In addition, it needs to be determined whether the use of tacks, staples or sutures is the best method of fixing the strips to the promontory [2]. Authors seem to agree that we need to fix the strip on the prevertebral ligament next to the vertebral body and not facing the disc.…”