Lumbosacral Discitis and Osteomyelitis after Sacrocolpopexy: A Case Series and Review of Management

Abstract

Introduction and Hypothesis

Lumbosacral discitis and osteomyelitis constitute a rare but devastating complication after mesh sacrocolpopexy for pelvic organ prolapse.

Methods

We present a case series of 3 patients at a single institution and a literature review of 30 patients suffering from this complication along with presenting symptoms, evaluation with laboratory and imaging findings, and management.

Results

Lumbosacral discitis can present after sacrocolpopexy of any route (abdominal, laparoscopic, and robotic) and with various suture types and tacking devices. Patients presented with lower back pain at varying time frames and with elevated inflammatory markers, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Conclusion

The majority of cases required both excision of pelvic mesh via laparotomy or laparoscopy in combination with an extended course of intravenous (IV) antibiotics.