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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Funding
This study was approved by the Baskent University Institutional Review Board and supported by Baskent University Research Fund.
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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.
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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 31, 2431–2433 (2020). https://doi.org/10.1007/s00192-020-04331-3
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DOI: https://doi.org/10.1007/s00192-020-04331-3