Iliosacral bacterial arthritis and retroperitoneal abscess after tension-free vaginal mesh reconstruction

A 64-year-old woman presented with severe infection accompanied by iliosacral arthritis and retroperitoneal abscess after tension-free vaginal mesh reconstruction using polypropylene meshes (GyneMesh; Gynecare, Ethicon, Somerville, NJ, USA) for pelvic organ prolapsed quantification of stage 3 pelvic organ prolapse. Three weeks after the operation, she complained of high fever (39°C) and sharp pain from the left buttock down to the left lower limb. Computed tomography revealed a retroperitoneal abscess and osteolysis caused by iliosacral arthritis. Because the infection was not resolved by drainage and antibiotic therapy, the left portion of the mesh was removed. She recovered after mesh removal, and no recurrent abscess was observed in the CT after a 6-month follow-up. However, the patient complained of sporadic discomfort in the left buttock, and a blood examination performed during this period, revealed a slight elevation in the C-reactive protein level. Although this symptom was resolved by oral antibiotics, further follow-up was required.