Pelvic floor abscess secondary to gossypiboma following a total Prolift procedure

Abstract

Gossypiboma, which is derived from the Latin term “gossypium” (cotton), is retention of cotton material, where usually a gauze or abdominal sponge frequently causes morbidity and may result in death. Nonresorbable hemostatic aides include various forms of cotton and rayon-based hemostats (cottonoids and kites). Histologic examination typically shows a core of degenerating hemostatic agent surrounded by an inflammatory reaction. If the foreign body cannot be extruded, it remains in the abscess cavity and creates multiple fistulae. In such a case, the patient who is recovering well after surgery becomes chronically unwell and complains of multiple symptoms. Pelvic organ prolapse (POP) is a growing gynecologic problem because of the increased life expectancy of women and the many available medical resources in our country. Women now have a lifetime risk of 11% for surgery intervention for POP [1]. Surgical therapy for POP has been a proliferation in techniques and materials that are intended to improve prolapse reduction. Therefore, surgery with implantation of mesh or graft materials has become increasingly popular over the past decade due to the excellent short-term cure rate [2]. Although synthetic mesh has the advantage of strength and durability, it has a drawback of graft encapsulation with subsequent infection and erosion. In addition, estrogen deficiency in menopause alters vaginal vascularization [3] and pH, which causes symptoms of urogenital atrophy, including pruritus, dryness, and dyspareunia. Consequently, these changes may contribute to poor healing of a vaginal wound following transvaginal mesh surgery, making the exposure of