Lumbosacral discitis as a rare complication of laparoscopic sacrocolpopexy

Abstract

Introduction and hypothesis

Sacrocolpopexy is considered to be the gold-standard procedure for apical compartment prolapse. However, complications such as sacral hemorrhage, small bowel obstruction, port site herniation, mesh erosion, mesh exposure, and occasionally discitis may occur. The aim of this study is to show laparoscopic treatment of L5–S1 discitis 3 months following laparoscopic sacrocolpopexy.

Methods

Two surgical interventions of a case with narrated video footage is presented.

Results

Laparoscopic sacrocolpopexy following hysterectomy in the first part and re-laparoscopy because of a diagnosis of discitis refractory to medical treatment, and removal of mesh along with anterior L5–S1 discectomy for curative debridement in the second part is demonstrated.

Conclusion

Frequency of postoperative discitis has been increased by the widespread use of a laparoscopic approach. In order to reduce the complication rate, surgical technique allowing the needle to penetrate only the depth of the anterior longitudinal ligament and usage of monofilament suture for mesh attachment is recommended. In treatment, removal of the sacral mesh, and even extensive tissue debridement, may be necessary.

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References

  1. 1.

    Gungor Ugurlucan F, Yasa C, Demir O, Basaran S, Bakir B, Yalcin O. Long-term follow-up of a patient with spondylodiscitis after laparoscopic sacrocolpopexy: an unusual complication with a review of the literature. Urol Int. 2019;103(3):364–8.

    Article  Google Scholar 

  2. 2.

    Matthews CA. Minimally invasive sacrocolpopexy: how to avoid short and long-term complications. Curr Urol Rep. 2016;17:81.

    Article  Google Scholar 

  3. 3.

    Kapoor B, Toms A, Hooper P, Fraser AM, Cox CV. Infective lumbar discitis following laparoscopic sacrocolpopexy. J R Coll Surg Edinb. 2002;47(5):709–10.

    PubMed  Google Scholar 

  4. 4.

    Nunez-Pereira S, Huhmann NV, Rheinwalt KP, Bullman V. Lumbosacral spondylodiscitis due to rectal fistula following mesh penetration 7 years after sacrocolpopexy. Int J Surg Case Rep. 2016;24:219–22.

    CAS  Article  Google Scholar 

  5. 5.

    Yeom JA, Lee IS, Suh HB, Song YS, Song JW. Magnetic resonance imaging findings of early spondylodiscitis: interpretive challenges and atypical findings. Korean J Radiol. 2016;17:565–80.

    Article  Google Scholar 

  6. 6.

    Rajamaheswari N, Agarwal S, Seethalakshmi K. Lumbosacral spondylodiscitis: an unusual complication of abdominal sacrocolpopexy. Int Urogynecol J. 2012;23(3):375–7.

    CAS  Article  Google Scholar 

  7. 7.

    Chamsy D, Lee T. Laparoscopic excision of sacrocolpopexy mesh. J Minim Invasive Gynecol. 2014;21:986.

    Article  Google Scholar 

  8. 8.

    Pan K, Cao L, Ryan NA, Wang Y, Xu H. Laparoscopic sacral hysteropexy versus laparoscopic sacrocolpopexy with hysterectomy for pelvic organ prolapse. Int Urogynecol J. 2016;27(1):93–101.

    Article  Google Scholar 

Download references

Funding

This study was approved by the Baskent University Institutional Review Board and supported by Baskent University Research Fund.

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Affiliations

Authors

Contributions

G. Doğan Durdağ: project development, manuscript writing; S. Alemdaroğlu: project development; E. Durdağ: data collection; S. Yüksel Şimşek: project development; T. Turunç: data collection; S. Yetkinel: data collection; Ş. Yılmaz Baran: data collection; H. Çelik: project development.

Corresponding author

Correspondence to Gülşen Doğan Durdağ.

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The authors declare that they have no conflicts of interest.

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Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

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Laparoscopic approach for pelvic organ prolapse and re-laparoscopy to treat a rare complication (MP4 107954 kb)

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Laparoscopic approach for pelvic organ prolapse and re-laparoscopy to treat a rare complication (MP4 107954 kb)

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Doğan Durdağ, G., Alemdaroğlu, S., Durdağ, E. et al. Lumbosacral discitis as a rare complication of laparoscopic sacrocolpopexy. Int Urogynecol J (2020). https://doi.org/10.1007/s00192-020-04331-3

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Keywords

  • Complications
  • Discitis
  • Laparoscopic
  • Mesh
  • Sacrocolpopexy