Sacral osteomyelitis after laparoscopic sacral colpopexy performed after a recent dental extraction: a case report.

Title

Sacral osteomyelitis after laparoscopic sacral colpopexy performed after a recent dental extraction: a case report.

Creator

Apostolis Costas A; Heiselman Cassandra

Publisher

Female pelvic medicine & reconstructive surgery

Date

2014
2014-12

Description

BACKGROUND: Sacral osteomyelitis and subsequent discitis is a rare complication after laparoscopic sacral colpopexy to repair apical vaginal prolapse. CASE: We present a patient who developed Bacteroides fragilis sacral osteomyelitis and discitis after laparoscopic sacrocolpopexy with synthetic monofilament mesh and sacral titanium coil fixation. The patient had undergone dental extraction of 3 infected teeth approximately 2 weeks before sacrocolpopexy for stage IV apical vaginal prolapse. Computed tomography and magnetic resonance imaging (MRI) confirmed sacral osteomyelitis and discitis along with Bacteroides fragilis bacteremia approximately a week and a half after the original surgery. The patient was followed up with serial MRIs of the spine which revealed degeneration at the sacral promontory. The patient underwent successful removal of the entire mesh and sacral titanium coils with resolution of her symptoms. Follow-up MRI of the spine revealed resolution of her sacral osteomyelitis. CONCLUSIONS: Sacral osteomyelitis is a rare complication after sacrocolpopexy for pelvic organ prolapse repair. There should be a high index of suspicion for patients presenting with disproportionate low back pain and vague symptoms after surgery. Recent oral surgery may increase the risk of bacteremia and subsequent infectious morbidity after sacrocolpopexy with the use of synthetic mesh for prolapse repair.

Subject

*Bacteroides fragilis; Aged; Bacteroides Infections/*etiology; Discitis/etiology; Female; Humans; Laparoscopy/methods; Osteomyelitis/*etiology; Pelvic Organ Prolapse/surgery; Postoperative Complications/etiology; Sacrum/*surgery; Tooth Extraction/*adverse effects; Vagina/surgery

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

e5–7

Issue

6

Volume

20

Citation

Apostolis Costas A; Heiselman Cassandra, “Sacral osteomyelitis after laparoscopic sacral colpopexy performed after a recent dental extraction: a case report.,” NEOMED Bibliography Database, accessed April 20, 2021, https://neomed.omeka.net/items/show/4421.

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