Entero mesh vaginal fistula secondary to abdominal sacral colpopexy

BACKGROUND: Abdominal sacral colpopexy is a popular method for resupporting the vaginal apex. Bleeding and infection are die most common complications. We report a complication resulting in a small bowel fistula. CASE: A 48-year-old woman developed a chronic vaginal discharge 4-6 months after routine abdominal sacral colpopexy in which a velour mesh remained exposed in the pelvis. Conservative measures failed to control the intermittent copious discharge from the upper vaginal vault where the mesh was visualized. At laparotomy, an entero mesh vaginal fistula was discovered. Excellent long-term results were obtained by removal of the mesh along with resection of the involved small intestine. CONCLUSION: At the time of abdominal sacral colpopexy, we recommend that mesh not remain exposed in the pelvis. (C) 2004 by The American College of Obstetricians and Gynecologists.