About
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
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
Procedure for reviewingReviewers 2023-2024
ISSN 0300-9092 (Print)
ISSN 2412-5679 (Online)
About
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
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
Procedure for reviewingReviewers 2023-2024
Logout
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

  1. Беженарь В.Ф., Линде В.А., Плеханов А.Н., ред. Влагалищный доступ в гинекологии. Руководство для врачей. 2-е изд., доп. М.: ГЭОТАР-Медиа; 2025. 216 с. [Bezhenar V.F., Linde V.A., Plekhanov A.N., eds. Vaginal access in gynecology. A guide for doctors. 2nd ed. Moscow: GEOTAR-Media; 2025. 216 p. (in Russian)].
  2. Mavrogenis A.F., Megaloikonomos P.D., Igoumenou V.G., Panagopoulos G.N., Giannitsioti E., Papadopoulos A. et al. Spondylodiscitis revisited. EFORT Open Rev. 2017; 2(11): 447-61. https://dx.doi.org/10.1302/2058-5241.2.160062
  3. Берг П.А., Ящук А.Г., Мусин И.И., Фаткуллина Ю.Н., Берг Э.А. Пролапс органов малого таза: факторы риска и возможности профилактики. Медицинский вестник Башкортостана. 2022; 17(1): 83-8. [Berg P.A., Yaschuk A.G., Musin I.I., Fatkullina Yu.N., Berg E.A. Pelvic organ prolapse: risk factors and prevention opportunities. Medical Bulletin of Bashkortostan. 2022; 17(1): 83-8 (in Russian)].
  4. Дубинская Е.Д., Гаспаров А.С., Мацкевич Е.Н. Клинико-анатомические особенности пациенток с апикальным пролапсом. Акушерство и гинекология. 2025; 7: 130-7. [Dubinskaya E.D., Gasparov A.S., Matskevich E.N. Clinical and anatomical features of patients with apical prolapse. Obstetrics and Gynecology. 2025; (7): 130-7 (in Russian)]. https://dx.doi.org/10.18565/aig.2025.154
  5. 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: 43-8. https://dx.doi.org/10.1016/j.ejogrb.2015.08.003
  6. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Выпадение женских половых органов. М.; 2024. 23 с. [Ministry of Health of the Russian Federation. Clinical guidelines. Prolapse of the female genital organs. Moscow; 2024. 23 p. (in Russian)].
  7. 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(6): 554-6. French. https://dx.doi.org/10.1016/s0003-3944(01)00554-5
  8. Betschart C., Cervigni M., Contreras Ortiz O., Doumouchtsis S.K., Koyama M., Medina C. et al. Management of apical compartment prolapse (uterine and vault prolapse): A FIGO Working Group report. Neurourol. Urodyn. 2017; 36(2): 507-13. https://dx.doi.org/10.1002/nau.22916
  9. Болдырева Ю.А., Цхай В.Б., Полстяной А.М., Полстяная О.Ю., Табакаева М.С. Современные методы хирургического лечения пролапса тазовых органов. Астраханский медицинский журнал. 2023; 18(3): 8-21. [Boldyreva Yu.A., Tskhay V.B., Polstyanoy A.M., Polstyanaya O.Yu., Tabakaeva M.S. Modern methods of surgical treatment of pelvic organ prolapse. Astrakhan Medical Journal. 2023; 18(3): 8-21 (in Russian)]. https://dx.doi.org/10.29039/1992-6499-2023-3-8-21
  10. 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(3): 364-8. https://dx.doi.org/10.1159/000494370
  11. Taylor G.B., Moore R.D., Miklos J.R. Osteomyelitis secondary to sacral colpopexy mesh erosion requiring laminectomy. Obstet. Gynecol. 2006; 107(2 Pt 2): 475-7. https://dx.doi.org/10.1097/01.AOG.0000187949.87223.06
  12. Беженарь В.Ф., Паластин П.М., Толибова Г.Х. Эрозии влагалища в отдаленные сроки после постановки синтетических имплантатов при гинекологических операциях. РМЖ. Медицинское обозрение. 2018; 10: 17-21. [Bezhenar V.F., Palastin P.M., Tolibova G.Kh. Vaginal erosion at a long time after synthetic implants insertion during gynecological surgery. RMJ. Medical review. 2018; 10: 17-21 (in Russian)].
  13. Hart S.R., Weiser E.B. Abdominal sacral colpopexy mesh erosion resulting in a sinus tract formation and sacral abscess. Obstet. Gynecol. 2004; 103(5 Pt 2): 1037-40. https://dx.doi.org/10.1097/01.AOG.0000121829.55491.0d
  14. Паластин П.М., Беженарь В.Ф., Петров А.В. Реакция местного иммунитета на введение полипропиленового синтетического имплантата (экспериментальное исследование). Российский вестник акушера-гинеколога. 2019; 19(2): 47-51. [Palastin P.M., Bezhenar V.F., Petrov A.V. A local immune response to a synthetic polypropylene implant (an experimental study). Russian bulletin of the obstetrician-gynecologist. 2019; 19(2): 47-51 (in Russian)]. https://dx.doi.org/10.17116/rosakush20191902147
  15. Патент № 2607656 Российская Федерация, МПК GOIN 33/48 (2006/01). Способ оценки биосовместимости сетчатых синтетических имплантатов: № 201511654515: заявл. 29.04.2015; опубл. 10.01.2017 / Паластин П.М., Беженарь В.Ф., Петров А.В.; заявитель НИИ акушерства, гинекологии и репродуктологии имени Д.О. Отта, Государственный НИИ особо чистых биопрепаратов. [Patent No. 2607656, Russian Federation, IPC GOIN 33/48 (2006/01). Method for Assessing the Biocompatibility of Mesh Synthetic Implants: No. 201511654515: filed on April 29, 2015; published on January 10, 2017 / Plastin P.M., Bezhenar V.F., Petrov A.V.; applicant: D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology, State Research Institute of Particularly Pure Biopreparations (in Russian)].
  16. Voelker A., Hoeckel M., Heyde C.E. Lumbosacral spondylodiscitis after sacral colpopexy of a sigmoid neovagina in a patient with vaginal melanoma. Surg. Infect. (Larchmt.). 2012; 13(2): 134-5. https://dx.doi.org/10.1089/sur.2011.083
  17. Propst K., Tunitsky-Bitton E., Schimpf M.O., Ridgeway B. Pyogenic spondylodiscitis associated with sacral colpopexy and rectopexy: report of two cases and evaluation of the literature. Int. Urogynecol. J. 2014; 25(1): 21-31. https://dx.doi.org/10.1007/s00192-013-2138-3
  18. Boyd B., Pratt T., Mishra K. Fungal lumbosacral osteomyelitis after robotic-assisted laparoscopic sacrocolpopexy. Female Pelvic Med. Reconstr. Surg. 2018; 24(6): e46-8. https://dx.doi.org/10.1097/SPV.0000000000000612
  19. Brito L.G., Giraudet G., Lucot J.P., Cosson M. Spondylodiscitis after sacrocolpopexy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2015; 187: 72. https://dx.doi.org/10.1016/j.ejogrb.2015.02.024
  20. Jenson M.D.A., Scranton R., Antosh D.D., Simpson R.K. Lumbosacral osteomyelitis and discitis with phlegmon following laparoscopic sacral colpopexy. Cureus. 2016; 8(7): e671. https://dx.doi.org/10.7759/cureus.671
  21. Tymchak Z.A., Epp A., Fourney D.R. Lumbosacral discitis-osteomyelitis after mesh abdominosacrocolpopexy. Spine J. 2015; 15(1): 194-5. https://dx.doi.org/10.1016/j.spinee.2014.08.004
  22. 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(8): 1074-8. French.
  23. Cranney A., Feibel R., Toye B.W., Karsh J. Osteomyelitis subsequent to abdominal-vaginal sacropexy. J. Rheumatol. 1994; 21(9): 1769-70.
  24. Cottle L., Riordan T. Infectious spondylodiscitis. J. Infect. 2008; 56(6): 401-12. https://dx.doi.org/10.1016/j.jinf.2008.02.005
  25. Vujovic Z., Cuarana E., Campbell K.L., Valentine N., Koch S., Ziyaie D. Lumbosacral discitis following laparoscopic ventral mesh rectopexy: a rare but potentially serious complication. Tech. Coloproctol. 2015; 19(4): 263-5. https://dx.doi.org/10.1007/s10151-015-1279-4
  26. Nunez-Pereira S., Huhmann N.V., Rheinwalt K.P., Bullmann V. Lumbosacral spondylodiscitis due to rectal fistula following mesh penetration 7 years after colpopexy. Int. J. Surg. Case Rep. 2016; 24: 219-22. https://dx.doi.org/10.1016/j.ijscr.2016.04.047
  27. Apostolis C.A., Heiselman C. Sacral osteomyelitis after laparoscopic sacral colpopexy performed after a recent dental extraction: a case report. Female Pelvic Med. Reconstr. Surg. 2014; 20(6): e5-7. https://dx.doi.org/10.1097/SPV.0000000000000092
  28. Rosinsky P., Mandler S., Netzer N., Ady M., Elmaliache D., Sagiv S. et al. Antibiotic-resistant spondylodiscitis with canal invasion and aggressive evolution to epidural abscess: a case series of spontaneous occurrence in 16 patients. Int. J. Spine Surg. 2018; 12(6): 743-50. https://dx.doi.org/10.14444/5093
  29. Anand M., Tanouye S.L., Gebhart J.B. Vesicosacrofistulization after robotically assisted laparoscopic sacrocolpopexy. Female Pelvic Med. Reconstr. Surg. 2014; 20(3): 180-3. https://dx.doi.org/10.1097/SPV.0000000000000033
  30. Downing K.T. Vertebral osteomyelitis and epidural abscess after laparoscopic uterus-preserving cervicosacropexy. J. Minim. Invasive Gynecol. 2008; 15(3): 370-2. https://dx.doi.org/10.1016/j.jmig.2007.12.006
  31. Roth T.M., Reight I. Laparoscopic mesh explantation and drainage of sacral abscess remote from transvaginal excision of exposed sacral colpopexy mesh. Int. Urogynecol. J. 2012; 23(7): 953-5. https://dx.doi.org/10.1007/s00192-011-1630-x
  32. Draaisma W.A., van Eijck M.M., Vos J., Consten E.C. Lumbar discitis after laparoscopic ventral rectopexy for rectal prolapse. Int. J. Colorectal. Dis. 2011; 26(2): 255-6. https://dx.doi.org/10.1007/s00384-010-0971-0
  33. Muffly T.M., Diwadkar G.B., Paraiso M.F. Lumbosacral osteomyelitis after robot-assisted total laparoscopic hysterectomy and sacral colpopexy. Int. Urogynecol. J. 2010; 21(12): 1569-71. https://dx.doi.org/10.1007/s00192-010-1187-0
  34. Collins S.A., Tulikangas P.K., LaSala C.A., Lind L.R. Complex sacral abscess 8 years after abdominal sacral colpopexy. Obstet. Gynecol. 2011; 118(2 Pt 2): 451-4. https://dx.doi.org/10.1097/AOG.0b013e3182234e7c
  35. Weidner A.C., Cundiff G.W., Harris R.L., Addison W.A. Sacral osteomyelitis: an unusual complication of abdominal sacral colpopexy. Obstet. Gynecol. 1997; 90: 689-91. https://dx.doi.org/10.1016/s0029-7844(97)00306-2
  36. Жакиев Н.С. Лапароскопическая промонтофиксация в лечении генитального пролапса. Актуальные проблемы теоретической и клинической медицины. 2021; 1(31): 151-5. [Zhakiev N.S. Laparoscopic promontofixation in the treatment of genital apical prolapse. Current problems of theoretical and clinical medicine. 2021; 1(31): 151-5 (in Russan)].
  37. Rajamaheswari N., Agarwal S., Seethalakshmi K. Lumbosacral spondylodiscitis: an unusual complication of abdominal sacrocolpopexy. Int. Urogynecol. J. 2012; 23(3): 375-7. https://dx.doi.org/10.1007/s00192-011-1547-4
  38. Nosseir S.B., Kim Y.H., Lind L.R., Winkler H.A. Sacral osteomyelitis after robotically assisted laparoscopic sacral colpopexy. Obstet. Gynecol. 2010; 116(Suppl. 2): 513-5. https://dx.doi.org/10.1097/AOG.0b013e3181e10ea6
  39. Salman M.M., Hancock A.L., Hussein A.A., Hartwell R. Lumbosacral spondylodiscitis: an unreported complication of sacrocolpopexy using mesh. BJOG. 2003; 110(5): 537-8.
  40. Beloosesky Y., Grinblat J., Dekel A., Rabinerson D. Vertebral osteomyelitis after abdominal colposacropexy. Acta Obstet. Gynecol. Scand. 2002; 81(6): 567-8. https://dx.doi.org/10.1034/j.1600-0412.2002.810617.x
  41. Grimes C.L., Tan-Kim J., Garfin S.R., Nager C.W. Sacral colpopexy followed by refractory Candida albicans osteomyelitis and discitis requiring extensive spinal surgery. Obstet. Gynecol. 2012; 120(2 Pt 2): 464-8. https://dx.doi.org/10.1097/AOG.0b013e318256989e
  42. Kapoor B., Toms A., Hooper P., Fraser A.M., Cox C.W. Infective lumbar discitis following laparascopic sacrocolpopexy. J. R. Coll. Surg. Edinb. 2002; 47(5): 709-10.

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

Similar Articles

№10 / 2018
Smolnova T.Yu., Chuprynin V.D.
Genital prolapse: a look at the problem
№8 / 2023
Cheremin M.M., Smolnova T.Yu., Chuprynin V.D., Chursin V.V., Melnikov M.V.
The place of vaginal sacrospinal fixation in the surgical treatment of genital prolapse
№9 / 2025
Melnik P.S., Katsura K.S., Posnova K.N., Lologaeva M.S., Aryutin D.G.
A three-year experience of a post-hysterectomy apical prolapse surgical treatment in menopausal women
№9 / 2019
Krasnopolsky V.I., Popov A.A., Krasnopolskaya K.V., Fedorov A.A.
Five-year use of robotic surgery in operative gynecology: summary and prospects
№11 / 2022
Berg P.A., Musin I.I., Yaschuk A.G., Naftulovich R.A., Battalova G.Yu.
Long-term results of surgical treatment of pelvic organ prolapse using prosthetic mesh
By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.