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- W4323536748 abstract "We present a patient’s clinical course of lumbosacral osteomyelitis after robotic-assisted sacrocolpopexy including surgical footage of mesh excision and discussion of the importance of timely diagnosis. Osseous infections rarely occur after minimally invasive sacrocolpopexy. The exact incidence remains unknown, however a retrospective cohort study by Stork et al in 2021 suggested an incidence of less than 1 in 1,000 cases. Our patient was a 70 year old female with history of stage 3 anterior/apical pelvic organ prolapse, stress urinary incontinence, and osteoarthritis. She underwent robotic-assisted total laparoscopic hysterectomy, Burch colposuspension, and sacrocolpopexy. She struggled with onset of postoperative lower back pain and underwent MRI of the lumbar spine by postoperative week 7, which confirmed L5-S1 discitis osteomyelitis. She underwent re-operation with robotic-assisted mesh excision. The mesh was purulent upon excision with infected appearing tissue from the vaginal cuff to the peritoneal tunnel along the posterior pelvic wall. Patient was clinically improving at 3 months following mesh excision. Bone biopsy and culture were performed at postoperative month 4, confirming no osteomyelitis. Lumbosacral osteomyelitis is a rare postoperative complication after minimally-invasive sacrocolpopexy. Delay in diagnosis has been reported, and back pain may be the only presenting symptom. Our patient had a history of osteoarthritis confounding her workup of postoperative back pain. Patient positioning during robotic surgery is an additional confounding factor. Overall, we learned that an MRI lumbar spine should be considered for any patient that complains of back pain after sacrocolpopexy. Clinical suspicion is warranted to achieve timely diagnosis and treatment. Lumbosacral osteomyelitis after robotic sacrocolpopexy is a rare postoperative complication that requires a high level of clinical suspicion to achieve timely diagnosis and treatment to avoid life changing complications." @default.
- W4323536748 created "2023-03-09" @default.
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- W4323536748 date "2023-03-01" @default.
- W4323536748 modified "2023-09-27" @default.
- W4323536748 title "Lumbosacral osteomyelitis after robotic sacrocolpopexy" @default.
- W4323536748 doi "https://doi.org/10.1016/j.ajog.2022.12.270" @default.
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