Mesh excision secondary to spondylodiscitis after colposacropexy graft rejection: a step by step video

INTRODUCTION

Spondylodiscitis secondary to colposacropexy is an extremely rare entity. Infection and mesh rejection are the main causes. Removal of the mesh is essential for patient's recovery and it can be a very challenging surgical procedure.

CASE

A 72-year-old woman presented with severe low back pain in the context of a recent colposacropexy. Magnetic resonance imaging was performed and spondylodiscitis secondary to prolapse correction surgery with mesh was suspected. In order to ensure an adequate recovery, removal of the mesh was required.

CONCLUSIONS

Spondylodiscitis secondary to colposacropexy should be suspected when the patient starts with moderate lumbar pain and is not correctly controlled with first-level analgesia. Infection or mesh rejection should be considered. Mesh rejection should be suspected when the patient does not improve after antibiotics. Complete removal of the mesh is needed in order to ensure the patient's recovery.

Thyroid cancer. Survival in 148 cases followed for 10 years or more

One hundred forty-eight patients with differentiated carcinoma of the thyroid treated between May 1954 and April 1973 are presented. There were 89 papillary and 59 follicular carcinomas. They were classified according to Woolner criteria. Treatment consisted of surgery I-131 and thyroid hormone. Recurrences occurred in 8.7% of the patients, and lethality at the end of the observation period was 3.3%. The impact of histologic type, extent of the primary, and age of the patient at the time of treatment on prognosis were studied. The data were submitted to statistical analysis. This study revealed that these factors are determinant on prognosis. Best survival rates were observed in patients 40 years of age or younger at the time of treatment, in patients with intrathyroid papillary carcinomas, and in patients with noninvasive follicular carcinomas.