PDF herunterladen
CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(07): 570-577
DOI: 10.1055/s-0041-1735153
Case Report | Relato de Caso

Conservative Management of Spondylodiscitis after Laparoscopic Sacral Colpopexy: A Case Report and Review of Literature

Manejo conservador da espondilodiscite após colpopexia sacral laparoscópica: Relato de caso e revisão da literatura
Madalena Andrade Tavares 
1   Gynecology and Obstetrics Service, Hospital Vila Franca de Xira, Lisboa, Portugal
,
Ana Rita Silva 
1   Gynecology and Obstetrics Service, Hospital Vila Franca de Xira, Lisboa, Portugal
,
Marta Gomes de Melo 
1   Gynecology and Obstetrics Service, Hospital Vila Franca de Xira, Lisboa, Portugal
,
Márcia Pacheco 
2   Internal Medicine Service, Hospital Vila Franca de Xira, Lisboa, Portugal
,
Nuno Coutinho 
3   Orthopedics Service, Hospital Vila Franca de Xira, Lisboa, Portugal
,
Alexandre Ambrósio 
1   Gynecology and Obstetrics Service, Hospital Vila Franca de Xira, Lisboa, Portugal
,
Paula Tapadinhas 
1   Gynecology and Obstetrics Service, Hospital Vila Franca de Xira, Lisboa, Portugal
› Institutsangaben
› Weitere Informationen
   Lizenzen und Reprints

Abstract

Sacral colpopexy is one of the standard procedures to treat apical pelvic organ prolapse. In most cases, a synthetic mesh is used to facilitate the colposuspension. Spondylodiscitis is a rare but potentially serious complication that must be promptly diagnosed and treated, despite the lack of consensus in the management of this complication. We report one case of spondylodiscitis after a laparoscopic supracervical hysterectomy and sacral colpopexy treated conservatively. We also present a literature review regarding this rare complication. A conservative approach without mesh removal may be possible in selected patients (stable, with no vaginal lesions, mesh exposure or severe neurologic compromise). Hemocultures and culture of image-guided biopsies should be performed to direct antibiotic therapy. Conservative versus surgical treatment should be regularly weighted depending on clinical and analytical progression. A multidisciplinary team is of paramount importance in the follow-up of these patients.

Resumo

A colpopexia sacral é um dos procedimentos padrão para tratar o prolapso de órgãos pélvicos apical. Na maioria dos casos, uma tela sintética é usada para facilitar a colposuspensão. A espondilodiscite é uma complicação rara, mas potencialmente grave, que deve ser prontamente diagnosticada e tratada, apesar da falta de consenso no manejo dessa complicação. Relatamos um caso de espondilodiscite após histerectomia supracervical laparoscópica e colpopexia sacral tratada conservadoramente. Também apresentamos uma revisão da literatura sobre essa complicação rara. Uma abordagem conservadora sem remoção da tela pode ser possível em pacientes selecionadas (estáveis, sem lesões vaginais, exposição da tela ou comprometimento neurológico grave). Hemoculturas e cultura de biópsias guiadas por imagem devem ser realizadas para direcionar a antibioticoterapia. O tratamento conservador versus o cirúrgico deve ser avaliado regularmente, dependendo da progressão clínica e analítica. Uma equipe multidisciplinar é de suma importância no acompanhamento desses pacientes.

Keywords

spondylodiscitis - sacral colpopexy - pelvic organ prolapse - urogynecological mesh - discitis

Palavras-chave

espondilodiscite - colpopexia sacral - prolapso de órgãos pélvicos - tela uroginecológica - discite

Supplementary Material



Publikationsverlauf

Eingereicht: 21. Oktober 2020

Angenommen: 21. Juli 2021

Artikel online veröffentlicht:
30. August 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Barber MD. Pelvic organ prolapse. BMJ 2016; 354: i3853
    CrossrefPubMedSuche in Google Scholar
  • 2 Nygaard I, Brubaker L, Zyczynski HM, Cundiff G, Richter H, Gantz M. et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA 2013; 309 (19) 2016-2024
    CrossrefPubMedSuche in Google Scholar
  • 3 Campos S, Billone V, Durão M. et al. Complications of laparoscopic sacropexy: as harmless as they seem?. Acta Obstet Ginecol Port 2016; 10 (01) 21-31
    PubMedSuche in Google Scholar
  • 4 Matthews CA. Minimally invasive sacrocolpopexy: how to avoid short- and long-term complications. Curr Urol Rep. 2016; 17 (11) :81: 1-7
    CrossrefPubMedSuche in Google Scholar
  • 5 Nygaard IE, McCreery R, Brubaker L. et al; Pelvic Floor Disorders Network. Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 2004; 104 (04) 805-823
    CrossrefPubMedSuche in Google Scholar
  • 6 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
    CrossrefPubMedSuche in Google Scholar
  • 7 Propst K, Tunitsky-Bitton E, Schimpf MO, Ridgeway B. Pyogenic spondylodiscitis associatedwith sacral colpopexy and rectopexy: report of two cases and evaluation of the literature. Int Urogynecol J 2014; 25 (01) 21-31
    CrossrefPubMedSuche in Google Scholar
  • 8 Müller PC, Berchtold C, Kuemmerli C, Ruzza C, Z'Graggen K, Steinemann DC. Spondylodiscitis after minimally invasive recto- and colpo-sacropexy: Report of a case and systematic review of the literature. J Minim Access Surg 2020; 16 (01) 5-12
    CrossrefPubMedSuche in Google Scholar
  • 9 Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A. et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J 2016; 27 (02) 165-194
    CrossrefPubMedSuche in Google Scholar
  • 10 Paiva JA, Sá AB, Froes F. et al. Norma da Direção geral de saúde: Terapêutica de infeções do aparelho urinário: Norma DGS 015/2011 [Internet]. 2011 [cited 2021 Jan 12]. Available from: http://nocs.pt/wp-content/uploads/2015/11/Terapêutica-de-infeções-do-aparelho-urinário-comunidade.pdf
    PubMedSuche in Google Scholar
  • 11 Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK. et al; Infectious Diseases Society of America. 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 (06) e26-e46
    CrossrefPubMedSuche in Google Scholar
  • 12 Cheung WY, Luk KD. Pyogenic spondylitis. Int Orthop 2012; 36 (02) 397-404
    CrossrefPubMedSuche in Google Scholar
  • 13 Bernard L, Dinh A, Ghout I, Simo D, Zeller V, Issartel B. et al; Duration of Treatment for Spondylodiscitis (DTS) study group. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet 2015; 385 (9971): 875-882
    CrossrefPubMedSuche in Google Scholar
  • 14 Jenson MD AV, Scranton R, Antosh DD, Simpson RK. Lumbosacral osteomyelitis and discitis with phlegmon following laparoscopic sacral colpopexy. Cureus 2016; 8 (07) :e671: 1-8
    CrossrefPubMedSuche in Google Scholar
  • 15 Gungor Ugurlucan F, Yasa C, Demir O, Basaran S, Bakir B, Yalcin O. Long-term follow-up of a patient with spondylodiscitis after laparoscopic sacrocolpopexy: an unusual complication with a review of the literature. Urol Int 2019; 103 (03) 364-368
    CrossrefPubMedSuche in Google Scholar
  • 16 Qu DC, Chen HB, Yang MM, Zhou HG. Management of lumbar spondylodiscitis developing after laparoscopic sacrohysteropexy with a mesh: A case report and review of the literature. Medicine (Baltimore) 2019; 98 (49) :e18252: 1-7
    CrossrefPubMedSuche in Google Scholar
  • 17 Miksić NG, Kljaić Dujić M, Rejc Marko J, Voršič M, But I. Bacteroides fragilis sacral spondylodiscitis and epidural abscess after sacrocolpopexy: a case report and literature review. J Int Med Res 2019; 47 (09) 4568-4574
    CrossrefPubMedSuche in Google Scholar
  • 18 Sato H, Teramoto S, Sato K, Abe H. Surgical management of mesh infection following laparoscopic sacrocolpopexy and tension-free vaginal mesh surgery: a report of two cases with a literature review. IJU Case Rep 2018; 2 (01) 54-56
    CrossrefPubMedSuche in Google Scholar
  • 19 Boyd B, Pratt T, Mishra K. Fungal lumbosacral osteomyelitis after robotic-assisted laparoscopic sacrocolpopexy. Female Pelvic Med Reconstr Surg 2018; 24 (06) e46-e48
    CrossrefPubMedSuche in Google Scholar
  • 20 Gupta P, Ehlert M, Bartley J, Gilleran J, Killinger KA, Boura JA. et al. Perioperative outcomes, complications, and efficacy of robotic-assisted prolapse repair: a single institution study of 196 patients. Female Pelvic Med Reconstr Surg 2018; 24 (06) 408-411
    CrossrefPubMedSuche in Google Scholar
  • 21 Pasquer A, Djeudji F, Pechoux A, Barth X. Spondylodiscitis after rectopexy: diagnostic of a rare complication. Tech Coloproctol 2017; 21 (01) 63-64
    CrossrefPubMedSuche in Google Scholar
  • 22 Feng TS, Thum DJ, Anger JT, Eilber KS. Sacral osteomyelitis after robotic sacrocolpopexy. Female Pelvic Med Reconstr Surg 2016; 22 (01) e6-e7
    CrossrefPubMedSuche in Google Scholar
  • 23 Núñez-Pereira S, Huhmann NV, Rheinwalt KP, Bullmann V. Lumbosacral spondylodiscitis due to rectal fistula following mesh penetration 7 years after colpopexy. Int J Surg Case Rep 2016; 24: 219-222
    CrossrefPubMedSuche in Google Scholar
  • 24 Brito LG, Giraudet G, Lucot JP, Cosson M. Spondylodiscitis after sacrocolpopexy. Eur J Obstet Gynecol Reprod Biol 2015; 187: 72
    CrossrefPubMedSuche in Google Scholar
  • 25 Tymchak ZA, Epp A, Fourney DR. Lumbosacral discitis-osteomyelitis after mesh abdominosacrocolpopexy. Spine J 2015; 15 (01) 194-195
    CrossrefPubMedSuche in Google Scholar
  • 26 Vujovic Z, Cuarana E, Campbell KL, Valentine N, Koch S, Ziyaie D. Lumbosacral discitis following laparoscopic ventral mesh rectopexy: a rare but potentially serious complication. Tech Coloproctol 2015; 19 (04) 263-265
    CrossrefPubMedSuche in Google Scholar
  • 27 Kdous M, Elhouda Kraiem N, Zhioua F, Ferchiou M. Pyogenic spondylodiscitis after laparoscopic sacral colpopexy with staples. Gynécol Obstét Fertil 2015; 43 (06) 478-480
    CrossrefPubMedSuche in Google Scholar
  • 28 Arsene E, Giraudet G, Lucot JP, Rubod C, Cosson M. Sacral colpopexy: long-term mesh complications requiring reoperation (s). Int Urogynecol J 2015; 26 (03) 353-358
    CrossrefPubMedSuche in Google Scholar
  • 29 Probst P, Knoll SN, Breitenstein S, Karrer U. Vertebral discitis after laparoscopic resection rectopexy: a rare differential diagnosis. J Surg Case Rep 2014; 2014 (08) rju075
    CrossrefPubMedSuche in Google Scholar
  • 30 Anand M, Tanouye SL, Gebhart JB. Vesicosacrofistulization after robotically assisted laparoscopic sacrocolpopexy. Female Pelvic Med Reconstr Surg 2014; 20 (03) 180-183
    CrossrefPubMedSuche in Google Scholar
  • 31 Apostolis CA, Heiselman C. Sacral osteomyelitis after laparoscopic sacral colpopexy performed after a recent dental extraction: a case report. Female Pelvic Med Reconstr Surg 2014; 20 (06) e5-e7
    CrossrefPubMedSuche in Google Scholar
  • 32 Roth TM, Reight I. Laparoscopic mesh explantation and drainage of sacral abscess remote from transvaginal excision of exposed sacral colpopexy mesh. Int Urogynecol J 2012; 23 (07) 953-955
    CrossrefPubMedSuche in Google Scholar
  • 33 Voelker A, Hoeckel M, Heyde CE. Lumbosacral spondylodiscitis after sacral colpopexy of a sigmoid neovagina in a patient with vaginal melanoma. Surg Infect (Larchmt) 2012; 13 (02) 134-135
    CrossrefPubMedSuche in Google Scholar
  • 34 Rajamaheswari N, Agarwal S, Seethalakshmi K. Lumbosacral spondylodiscitis: an unusual complication of abdominal sacrocolpopexy. Int Urogynecol J 2012; 23 (03) 375-377
    CrossrefPubMedSuche in Google Scholar
  • 35 Grimes CL, Tan-Kim J, Garfin SR, Nager CW. Sacral colpopexy followed by refractory Candida albicans osteomyelitis and discitis requiring extensive spinal surgery. Obstet Gynecol 2012; 120 (2 Pt 2): 464-468
    CrossrefPubMedSuche in Google Scholar
  • 36 Draaisma WA, van Eijck MM, Vos J, Consten EC. Lumbar discitis after laparoscopic ventral rectopexy for rectal prolapse. Int J Colorectal Dis 2011; 26 (02) 255-256
    CrossrefPubMedSuche in Google Scholar
  • 37 Collins SA, Tulikangas PK, LaSala CA, Lind LR. Complex sacral abscess 8 years after abdominal sacral colpopexy. Obstet Gynecol 2011; 118 (2 Pt 2): 451-454
    CrossrefPubMedSuche in Google Scholar
  • 38 Muffly TM, Diwadkar GB, Paraiso MF. Lumbosacral osteomyelitis after robot-assisted total laparoscopic hysterectomy and sacral colpopexy. Int Urogynecol J 2010; 21 (12) 1569-1571
    CrossrefPubMedSuche in Google Scholar
  • 39 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 (03) 268-269
    CrossrefPubMedSuche in Google Scholar
  • 40 Nosseir SB, Kim YH, Lind LR, Winkler HA. Sacral osteomyelitis after robotically assisted laparoscopic sacral colpopexy. Obstet Gynecol 2010; 116 (Suppl. 02) 513-515
    CrossrefPubMedSuche in Google Scholar
  • 41 Descargues G, Bouzouita A, Grise P. [Infectious spondylodiscitis after a laparoscopic sacrocolpopexy: about one case]. Gynécol Obstét Fertil 2009; 37 (02) 183-185
    CrossrefPubMedSuche in Google Scholar
  • 42 Downing KT. Vertebral osteomyelitis and epidural abscess after laparoscopic uterus-preserving cervicosacropexy. J Minim Invasive Gynecol 2008; 15 (03) 370-372
    CrossrefPubMedSuche in Google Scholar
  • 43 Taylor GB, Moore RD, Miklos JR. Osteomyelitis secondary to sacral colpopexy mesh erosion requiring laminectomy. Obstet Gynecol 2006; 107 (2 Pt 2): 475-477
    CrossrefPubMedSuche in Google Scholar
  • 44 Hart SR, Weiser EB. Abdominal sacral colpopexy mesh erosion resulting in a sinus tract formation and sacral abscess. Obstet Gynecol 2004; 103 (5 Pt 2): 1037-1040
    CrossrefPubMedSuche in Google Scholar
  • 45 Salman MM, Hancock AL, Hussein AA, Hartwell R. Lumbosacral spondylodiscitis: an unreported complication of sacrocolpopexy using mesh. BJOG 2003; 110 (05) 537-538
    CrossrefPubMedSuche in Google Scholar
  • 46 Beloosesky Y, Grinblat J, Dekel A, Rabinerson D. Vertebral osteomyelitis after abdominal colposacropexy. Acta Obstet Gynecol Scand 2002; 81 (06) 567-568
    CrossrefPubMedSuche in Google Scholar
  • 47 Kapoor B, Toms A, Hooper P, Fraser AM. C WF M Cox. Infective lumbar discitis following laparascopic sacrocolpopexy. J R Coll Surg Edinb 2002; 47 (05) 709-710
    PubMedSuche in Google Scholar
  • 48 Cosson M, Narducci F, Querleu D, Crépin G. [Experimental use of laparoscopic material: report of a case of spondylodiscitis after laparoscopic sacropexy with Taker]. Ann Chir 2001; 126 (06) 554-556 French
    CrossrefPubMedSuche in Google Scholar
  • 49 Gertzbein SD, Hollopeter M, Bertini Jr JE, Murdock HD. An unusual cause of lumbar discitis. Spine (Phila Pa 1976) 1998; 23 (06) 734-736
    CrossrefPubMedSuche in Google Scholar
  • 50 Weidner AC, Cundiff GW, Harris RL, Addison WA. Sacral osteomyelitis: an unusual complication of abdominal sacral colpopexy. Obstet Gynecol 1997; 90 (4 Pt 2): 689-691
    CrossrefPubMedSuche in Google Scholar
  • 51 Cranney A, Feibel R, Toye BW, Karsh J. Osteomyelitis subsequent to abdominal-vaginal sacropexy. J Rheumatol 1994; 21 (09) 1769-1770
    PubMedSuche in Google Scholar
  • 52 Cailleux N, Daragon A, Laine F, Deshayes P, Le Loët X, Duval C. [Infectious spondylodiscitis after a cure for genital prolapse. 5 cases]. J Gynecol Obstet Biol Reprod (Paris) 1991; 20 (08) 1074-1078
    PubMedSuche in Google Scholar
  • 53 Wagner L, Meurette G, Vidart A, Warembourg S, Terassa J-B, Berrogain N. et al. [Laparoscopic sacrocolpopexy for pelvic organ prolapse: guidelines for clinical practice]. Prog Urol 2016; 26 (Suppl. 01) S27-S37
    CrossrefPubMedSuche in Google Scholar
  • 54 Good MM, Abele TA, Balgobin S, Schaffer JI, Slocum P, McIntire D. et al. Preventing L5-S1 discitis associated with sacrocolpopexy. Obstet Gynecol 2013; 121 (2 Pt 1): 285-290
    CrossrefPubMedSuche in Google Scholar