International Urogynecology Journal

, Volume 24, Issue 10, pp 1765–1767

Necrotising fasciitis after hysterectomy and concomitant transvaginal mesh repair in a patient with pelvic organ prolapse

  • Dmitry Y. Pushkar
  • Mikhail I. Vasilchenko
  • George R. Kasyan
Case Report

DOI: 10.1007/s00192-013-2047-5

Cite this article as:
Pushkar, D.Y., Vasilchenko, M.I. & Kasyan, G.R. Int Urogynecol J (2013) 24: 1765. doi:10.1007/s00192-013-2047-5

Abstract

Necrotising fasciitis is a severe form of soft tissue infection. Herein, we present an unreported complication of the transvaginal repair of a pelvic organ prolapse (POP) with trocar-guided polypropylene mesh and a concomitant hysterectomy. A 61-year-old Caucasian female who had been using an intrauterine device (IUD) for 30 years presented with a stage 3 pelvic organ prolapse. A genital ultrasound examination confirmed the presence of an IUD, but found no endometrial abnormalities. The surgical management was limited to a transvaginal hysterectomy and simultaneous anterior vaginal wall repair augmented with trocar-guided mesh. A morphological examination of the removed uterus confirmed the presence of the intrauterine device and additionally found endometrial cancer (T1N0M0), which was not revealed during the preoperative ultrasound. Within 6 days of the surgery, she developed anaerobic bilateral necrotising fasciitis on both thighs. Non-clostridial streptococci were identified in the wound. After 18 days of intensive care, the patient died of fatal coagulopathy.

Keywords

Necrotising fasciitis Anaerobic Intrauterine device Prolapse Mesh Endometrial cancer 

Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • Dmitry Y. Pushkar
    • 1
  • Mikhail I. Vasilchenko
    • 2
  • George R. Kasyan
    • 1
    • 3
  1. 1.Urology DepartmentMoscow State University of Medicine and DentistryMoscowRussia
  2. 2.General Surgery departmentMoscow City Hospital 50MoscowRussia
  3. 3.MoscowRussia

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