Multidisciplinary Management of Cutaneous Gluteus Vaginal Fistula After Sacrospinous Ligament Fixation

CRSLS. 2023 Mar 31;10(1):e2022.00085. doi: 10.4293/CRSLS.2022.00085. eCollection 2023 Jan-Mar.

Abstract

Introduction: 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.

Case description: 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.

Discussion: Multi-disciplinary approach should be considered in the treatment of chronic fistula status post SSLF, including interventional radiology, urogynecology, and minimally invasive gynecologic surgery.

Keywords: Gluteal cutaneous fistula; Gynecologic surgical procedures; Laparoscopy; Postoperative complication; Sacrospinous ligament fixation.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnostic imaging
  • Aged
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Ligaments, Articular
  • Pelvic Organ Prolapse* / surgery
  • Vaginal Fistula*