Bone anchors for stress urinary incontinence in 2004: con

Complications of anterior compartment vaginal surgery

Many complications can be associated with anterior compartment surgery of the vagina. With the integration of synthetic materials into the surgical armamentarium for the repair of stress urinary incontinence in the form of midurethral slings, and for the repair of vaginal prolapse as a primary procedure or to augment an existing repair, the spectrum of complications related to this type of surgery is evolving. Fortunately, these complications are mostly preventable, readily recognized, and/or reversible.

Actinomyces meyeri osteomyelitis of the symphysis pubis following pubovaginal sling

Previous reports of pubic osteomyelitis associated with bone anchors describe symptoms presenting 10 days to 12 months postoperatively with typical pathogens including Streptococcus, Staphylococcus, Citrobacter, and Pseudomonas (Fitzgerald et al., Int Urogynecol J 10:346-348, 1999 Enzler et al., J Bone Jt Surg Am 81-A(12):1736-1740, 1999; Graham and Dmochowski, J Urol 168:2055-2058, 2004; Fialkow et al., Urology 64(6):1127-1132, 2004; Matkov et al., J Urol 160(4):1427, 1998). This case illustrates the potential for protracted symptoms and delayed diagnosis of pubic osteomyelitis with the fastidious pathogen of Actinomyces meyeri.