A Unique Case of Rectosigmoid Mesh Erosion Presenting as Left Thigh Sinus Tract Abscess Following Laparoscopic Sacrocervicopexy

Abstract

Abstract

Background:

Mesh erosion is a well-known complication after use of mesh for pelvic organ prolapse repair. The most common site of mesh erosion is the vagina. Nonvaginal mesh erosions into bowel and bladder are rare. Mesh erosion into the bowel can be a devastating complication with significant morbidity and could need multiple surgeries for repair and recovery. Mesh erosion presenting as thigh sinus-tract abscess is unusual and rare.

Case:

A 41-year-old female had rectosigmoid mesh erosion after laparoscopic sacrocervicopexy; this condition presented with a recurrent left sinus-tract thigh abscess. Rectosigmoid mesh erosion, with a thigh sinus-tract abscess was suspected on the basis of local and pelvic examination findings as well as ultrasonography findings. This case was managed by excision of the mesh with closure of the sinus tract, and bowel diversion and repair.

Results:

This patient was asymptomatic after 3 years of follow-up.

Conclusions:

Total excision of the mesh with repair of the bowel defect seems to be an appropriate treatment for patients with mesh eroding into the bowel. Sometimes bowel diversion (ileostomy or colostomy) is needed. Any unusual anorectal or gynecologic symptom should alarm the physician, and the possibility of mesh erosion should be suspected.