Intractable Chronic Pelvic Pain Relieved After Bone Anchor Removal

Abstract

Operative cure of genuine stress incontinence remains a challenge. While no ideal technique has emerged, investigators have continued to modify available methods to be minimally invasive without significantly affecting long-term outcome. Transvaginal needle suspension is an established treatment for genuine stress incontinence in women. Suspension suture pull-through has been proposed as one of the possible causes of failure. While bone anchors provide a solid structure for fixation of suspension sutures, they have been associated with complications such as chronic pelvic pain, osteomyelitis and osteitis pubis.1 The associated pain can occasionally be intractable and difficult to manage. Although Graham and Dmochowski have reported severe pain following bladder neck suspension using bone anchors, to our knowledge chronic intractable pain in the absence of infection has not been reported thus far.2 We report complete resolution of intractable pelvic pain following extraction of bone anchors in a 40-year-old woman who had undergone human dermal allograft pubovaginal slingplasty.