Sacrocolpopexy is the gold standard treatment for apical compartment prolapse with reported success rates of 78–100%. Spondylodiscitis is a rare complication of sacrocolpopexy and includes a spectrum of spinal infections such as discitis, osteomyelitis, epidural abscess, meningitis, subdural empyema, and spinal cord abscess. Here we report a case of spondylodiscitis following laparoscopic sacrocolpopexy with long-term follow-up and discuss management of spondylodiscitis after abdominal sacrocolpopexy, with a review of the literature.

Keywords:
Sacrocolpopexy, Spondylodiscitis, Pelvic organ prolapse, Mesh
1.
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al: An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010; 21: 5–26.
2.
Wu JM, Matthews CA, Conover MM, Pate V, Jonsson Funk M: Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol 2014; 123: 1201–1206.
3.
Illiano E, Giannitsas K, Zucchi A, Di Biase M, Del Zingaro M, Bini V, Costantini E: Sacrocolpopexy for posthysterectomy vaginal vault prolapse: long-term follow-up. Int Urogynecol J 2016; 27: 1563–1569.
4.
Tyler KL: Acute pyogenic diskitis (spondylodiskitis) in adults. Rev Neurol Dis 2008; 5: 8–13.
5.
Gertzbein SD, Hollopeter M, Bertini JE Jr., Murdock HD: An unusual cause of lumbar discitis. Spine 1998; 23: 734–736.
6.
Rajamaheswari N, Agarwal S, Seethalakshmi K: Lumbosacral spondylodiscitis: an unusual complication of abdominal sacrocolpopexy. Int Urogynecol J 2012; 23: 375–377.
7.
Boden SD, Davis DO, Dina TS, et al: Postoperative diskitis: distinguishing early MR imaging findings from normal postoperative disk space changes. Radiology 1992; 184: 765–771.
8.
Tali ET: Spinal infections. Eur J Radiol 2004; 50: 120–133.
9.
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: 565–580.
10.
Go JL, Rothman S, Prosper A, Silbergleit R, Lerner A: Spine infections. Neuroimaging Clin N Am 2012; 22: 755–772.
11.
Guerado E, Cervan AM: Surgical treatment of spondylodiscitis. An update. Int Orthop 2012; 36: 413–420.
12.
Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, Hendershot EF, Holtom PD, Huddleston PM 3rd, Petermann GW, Osmon DR: 2015 Infectious Diseases Society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis 2015; 61:e26.
13.
Carragee EJ: The clinical use of magnetic resonance imaging in pyogenic vertebral osteomyelitis. Spine 1997; 22: 780.
14.
Tijdink MM, Vierhout ME, Heesakkers JP, Withagen MI: Surgical management of mesh related complications after prior pelvic floor reconstructive surgery with mesh. Int Urogynecol J 2011; 22: 1395–1404.
15.
Kapoor B, Toms A, Hooper P, Fraser AM, Cox CW: Infective lumbar discitis following laparoscopic sacrocolpopexy. J R Coll Surg Edinb 2002; 47: 709–710.
16.
Salman MM, Hancock AL, Hussein AA, Hartwell R: Lumbosacral spondylodiscitis: an unreported complication of sacrocolpopexy using mesh. BJOG 2003; 110: 537–538.
17.
Hart SR, Weiser EB: Abdominal sacral colpopexy mesh erosion resulting in a sinus tract formation and sacral abscess. Obstet Gynecol 2004; 103: 1037–1040.
18.
Dalwai R, Menon KV, Kumar RJ: Pyogenic diskitis of the L5-S1 disk space following inadvertent placement of a sacrocolpopexy screw. Int J Gynaecol Obstet 2010; 111: 268–269.
19.
Brito LG, Giraudet G, Lucot JP, Cosson M: Spondylodiscitis after sacrocolpopexy. Eur J Obstet Gynecol Reprod Biol 2015; 187: 72–77.
20.
Propst K, Tunitsky-Bitton E, Schimpf MO, Ridgeway B: Pyogenic spondylodiscitis associated with sacral colpopexy and rectopexy: report of two cases and evaluation of the literature. Int Urogynecol J 2014; 25: 21–31.
21.
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: 219–222.
22.
Api M, Kayatas S, Boza A: Spondylodiscitis following sacral colpopexy procedure: is it an infection or graft rejection? Eur J Obstet Gynecol Reprod Biol 2015; 194: 43–48.
23.
Anand M, Tanouye SL, Gebhart JB: Vesicosacrofistulization after robotically assisted laparoscopic sacrocolpopexy. Female Pelvic Med Reconstr Surg 2014; 20: 180–183.
24.
Chamsy D, Lee T: Laparoscopic excision of sacrocolpopexy mesh. J Minim Invasive Gynecol 2014; 21: 986.
25.
Florian-Rodriguez ME, Hamner JJ, Corton MM: First sacral nerve and anterior longitudinal ligament anatomy: clinical applications during sacrocolpopexy. Am J Obstet Gynecol 2017; 217: 607.e1–607.e4.
26.
Zacharakis D, Grigoriadis T, Bourgioti C, Pitsouni E, Protopapas A, Moulopoulos LA, Athanasiou S: Pre- and postoperative magnetic resonance imaging (MRI) findings in patients treated with laparoscopic sacrocolpopexy. Is it a safe procedure for all patients? Neurourol Urodyn 2018; 37: 316–321.
27.
Good MM, Abele TA, Balgobin S, et al: Preventing L5-S1 discitis associated with sacrocolpopexy. Obstet Gynecol 2013; 121: 285–290.
28.
Abernethy M, Vasquez E, Kenton K, Brubaker L, Mueller E: Where do we place the sacrocolpopexy stitch? A magnetic resonance imaging investigation. Female Pelvic Med Reconstr Surg 2013; 19: 31–33.
29.
Berger AA, Abramowitch S, Moalli PA: 3D vascular anatomy of the presacral space: impact of age and adiposity. Int Urogynecol J 2018, Epub ahead of print.
30.
Matthews CA: Minimally invasive sacrocolpopexy: how to avoid short- and long-term complications. Curr Urol Rep 2016; 17: 81.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.