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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2025№9
Spondylodiscitis as a complication after...

Spondylodiscitis as a complication after sacrocolpopexy

DOI
https://dx.doi.org/10.18565/aig.2025.148

Bezhenar V.F., Palastin P.M., Ivanov O.A.

Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia, St. Petersburg, Russia

Background: Sacrocolpopexy using a synthetic mesh implant is a highly effective method for the surgical correction of apical pelvic organ prolapse. Despite good long-term outcomes, the procedure is associated with the risk of developing mesh-associated complications, with purulent spondylodiscitis being the most severe. This complication has not been previously described in the Russian literature.
Objective: To highlight the issue of diagnosis and treatment of spondylodiscitis as a complication of sacrocolpopexy based on the analysis of a clinical case and data from modern literature.
Materials and methods: A clinical case of a 66-year-old female patient who developed spondylodiscitis at L5–S1, osteomyelitis, and a paraspinal abscess after laparoscopic sacrocolpopexy with total hysterectomy was analyzed. A review of modern approaches to the diagnosis and treatment of this complication was conducted. MRI and CT were used for verification of the diagnosis. After conservative antibiotic therapy proved ineffective, laparoscopic excision of the infected mesh implant was performed.
Results: Conservative antibiotic therapy failed to relieve the symptoms of spondylodiscitis. Laparoscopic removal of the infected polypropylene implant resulted in rapid regression of clinical symptoms: complete pain relief was noted on the 2nd postoperative day and the patient was discharged for outpatient treatment on the 4th day. Full rehabilitation was achieved within 20 days.
Conclusion: The presented case confirms that surgical excision of the infected mesh implant is the most effective treatment method, while antibiotic therapy is often ineffective. To minimize the risk of complications, it is important to strictly follow to the rules of asepsis and to avoid performing hysterectomy and placing a synthetic prosthesis simultaneously. Surgeons should maintain a high index of suspicion for this complication in patients presenting with low back pain postoperatively.

Authors’ contributions: Bezhenar V.F. – developing the concept and design of the study, approval of the final version of the article; Palastin P.M., Ivanov O.A. – collecting and processing the material, writing the text, editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patients signed informed consent for the publication of their data and and associated images.
For citation: Bezhenar V.F., Palastin P.M., Ivanov O.A. Spondylodiscitis as a complication after sacrocolpopexy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (9): 176-183 (in Russian)
https://dx.doi.org/10.18565/aig.2025.148

Keywords

sacrocolpopexy
spondylodiscitis
mesh implant
Full text (in Russian)

References

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Received 05.06.2025

Accepted 09.09.2025

About the Authors

Vitaly F. Bezhenar, Dr. Med. Sci., Professor, Head of the Departments of Obstetrics, Gynecology and Neonatology/Reproductology, Head of the Clinic of Obstetrics and Gynecology, Pavlov First State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, Leo Tolstoy str., 6-8; Main Supernumerary Specialist Obstetrician-Gynecologist of the Health Committee of St. Petersburg, eLibrary SPIN: 8626-7555, https://orcid.org/0000-0002-7807-4929
Peter M. Palastin, PhD, Teaching Assistant at the Department of Obstetrics, Gynecology and Neonatology, Pavlov First State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, Leo Tolstoy str., 6-8, eLibrary SPIN: 8008-8723, https://orcid.org/0000-0003-3502-2499
Oleg A. Ivanov, PhD Student, Department of Obstetrics, Gynecology and Neonatology, Senior Laboratory Assistant, Department of Obstetrics, Gynecology and Neonatology, Pavlov First State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, Leo Tolstoy str., 6-8, ivanoffmd@gmail.com, eLibrary SPIN: 8620-9749, https://orcid.org/0000-0002-6596-4105

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