Iliosacral bacterial arthritis and retroperitoneal abscess after tension-free vaginal mesh reconstruction

• Published in: International Urogynecology Journal Vol. 21; no. 6; pp. 753 - 755
• Main Authors: Chien, Hung-wu, Kumakura, Erika, Koyama, Masayasu
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01.06.2010; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - therapeutic use; Arthritis, Infectious - drug therapy; Arthritis, Infectious - etiology; Arthritis, Infectious - microbiology; Case Report; Female; Gynecology; Humans; Medicine; Medicine & Public Health; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Middle Aged; Osteomyelitis - etiology; Osteomyelitis - microbiology; Pelvic Organ Prolapse - surgery; Polypropylenes - adverse effects; Retropharyngeal Abscess - drug therapy; Retropharyngeal Abscess - etiology; Retropharyngeal Abscess - microbiology; Sacroiliac Joint - diagnostic imaging; Sacroiliac Joint - microbiology; Sacrum - microbiology; Staphylococcal Infections - drug therapy; Staphylococcal Infections - etiology; Suburethral Slings - adverse effects; Tomography, X-Ray Computed; Urology; Vancomycin - therapeutic use; Osteomyelitis; Pelvic organ prolapse; Vaginal mesh; Osteolysis; Bacterial arthritis; Abscess
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-009-1063-y

A 64-year-old woman presented with severe infection accompanied by iliosacral arthritis and retroperitoneal abscess after tension-free vaginal mesh reconstruction using polypropylene meshes (GyneMesh; Gynecare, Ethicon, Somerville, NJ, USA) for pelvic organ prolapsed quantification of stage 3 pelvic organ prolapse. Three weeks after the operation, she complained of high fever (39°C) and sharp pain from the left buttock down to the left lower limb. Computed tomography revealed a retroperitoneal abscess and osteolysis caused by iliosacral arthritis. Because the infection was not resolved by drainage and antibiotic therapy, the left portion of the mesh was removed. She recovered after mesh removal, and no recurrent abscess was observed in the CT after a 6-month follow-up. However, the patient complained of sporadic discomfort in the left buttock, and a blood examination performed during this period, revealed a slight elevation in the C-reactive protein level. Although this symptom was resolved by oral antibiotics, further follow-up was required.