(Video Poster 27) Recurrent Prolapse and Back Pain After Sacrocervicopexy with Surgical Tacks

Objectives: To review the clinical presentation, diagnostic methods, and management strategies of complications after sacrocolpopexy with use of surgical tacks.

Methods: We present a unique clinical case of prolapse recurrence with possible osteomyelitis after minimally invasive sacrocervicopexy necessitating surgical intervention and removal of sacral bone tacks with subsequent growth of C. Acnes in culture of the sacral mesh.

Clinical Relevance: Use of titanium surgical tacks for attachment of mesh to the anterior longitudinal ligament has been described as a safe alternative to suture attachment during sacrocolpopexy. While sacral osteomyelitis is a rare complication following sacrocolpopexy, use of surgical tacks at the sacrum introduces risk for infections associated with surgical hardware. As with management of sacral osteomyelitis, clinical presentation should be prioritized over imaging findings, removal of sacral sutures and/or hardware should be considered, and any implants/hardware removed should be sent to pathology for culture to facilitate appropriate antibiotic therapy.