Sato Hirotaka, Teramoto Sakiko, Sato Katsuhiko, Abe Hirokazu
Department of Urology Hokusuikai Kinen Hospital Ibaraki Japan.
Department of Urology Kikuna Memorial Hospital Kanagawa Japan.
IJU Case Rep. 2018 Dec 16;2(1):54-56. doi: 10.1002/iju5.12039. eCollection 2019 Jan.
The standard management for pelvic abscess or spondylodiscitis after reconstructive surgery previously involved total mesh excision, abscess drainage, and intravenous antibiotic administration. However, only few reports exist regarding the possibility of nonoperative management.
Postoperative mesh infection occurred in two cases of transvaginal mesh and laparoscopic sacrocolpopexy surgery for pelvic organ prolapse. In the first case, intravenous antibiotics were administered and debridement was performed. In the second case, intravenous antibiotics were administered, and local drainage was performed postoperatively, as sacral promontory infiltration was suspected. Diabetes was a comorbidity in both cases.
It is necessary to select patients suitable for vaginal or laparoscopic mesh placement for pelvic organ prolapse preoperatively on the basis of prior history of the patients and once the patients provide informed consent for surgery after being explained the possible complications of pelvic reconstructive surgery, such as mesh infection.
先前，重建手术后盆腔脓肿或脊椎椎间盘炎的标准治疗方法包括完全切除补片、脓肿引流和静脉注射抗生素。然而，关于非手术治疗可能性的报道很少。
两例盆腔器官脱垂经阴道补片和腹腔镜骶骨阴道固定术术后发生补片感染。第一例患者接受了静脉抗生素治疗并进行了清创术。第二例患者因怀疑骶岬浸润，接受了静脉抗生素治疗，并在术后进行了局部引流。两例患者均合并糖尿病。
有必要根据患者既往病史，术前选择适合盆腔器官脱垂阴道或腹腔镜补片置入的患者，并且一旦向患者解释盆腔重建手术可能的并发症，如补片感染后，患者已签署手术知情同意书。
