Kim Veronica, Seraji Shadi, Grigorescu Bogdan A, Hon Man, Hunt Daniel H, Nezhat Farr R
Department of Obstetrics and Gynecology, NYU Langone Hospital-Long Island, Mineola, NY.
Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, NYU Langone Hospital-Long Island, Mineola, NY.
CRSLS. 2023 Mar 31;10(1). doi: 10.4293/CRSLS.2022.00085. eCollection 2023 Jan-Mar.
Cutaneous gluteal vaginal fistula is a rare but significant postoperative complication which may present years after sacrospinous ligament fixation (SSLF) surgery There is limited data on the management of cutaneous vaginal fistula following SSLF.
This case report describes a 77-year-old who presents twenty years after SSLF with cutaneous gluteal vaginal abscess and fistula. She underwent successful management with CT-guided percutaneous drainage of gluteal abscess and placement of guiding cutaneous vaginal catheter, laparoscopic pelvic wall dissection and evaluation, and transvaginal localization and removal of the infected permanent suture.
Multi-disciplinary approach should be considered in the treatment of chronic fistula status post SSLF, including interventional radiology, urogynecology, and minimally invasive gynecologic surgery.
皮肤臀阴道瘘是一种罕见但严重的术后并发症,可能在骶棘韧带固定术(SSLF)数年之后出现。关于SSLF术后皮肤阴道瘘的处理数据有限。
本病例报告描述了一名77岁女性,在SSLF术后20年出现皮肤臀阴道脓肿和瘘管。她通过CT引导下经皮引流臀脓肿、放置引导性皮肤阴道导管、腹腔镜盆腔壁解剖和评估以及经阴道定位和取出感染的永久缝线,获得了成功治疗。
对于SSLF术后慢性瘘管状态的治疗,应考虑多学科方法,包括介入放射学、泌尿妇科和微创妇科手术。