Ahmed Hamid JABBAR, Santhosh PUTHURAYA, Aethele KHUNDA
Pelviperineology - 2025;44(3):126-129
Sacrospinous fixation (SSF) is a commonly used surgical procedure to treat advanced forms of prolapse. While generally considered low-risk, SSF can lead to complications, including rare sinus and or fistula formation. This report highlights two rare presentations of gluteal sinus formation and associated osteomyelitis years post-SSF, using ethibond (Ethicon Inc., Somerville, NJ, USA) sutures in both cases. The first patient is a 72-year-old woman who developed a right-sided gluteal-cutaneous sinus six years post-surgery, which resolved after suture removal and surgical treatment. The second, a 63-year-old woman, developed a chronic discharging sinus and osteomyelitis, which required a multidisciplinary approach. These cases highlight rare but serious SSF complications, particularly when using non-absorbable braided sutures like ethibond (Ethicon Inc., Somerville, NJ, USA). Similar cases reported in the literature suggest that these sutures may contribute to chronic inflammation, suture erosion, and sinus formation. Monofilament sutures may be a safer alternative, as they are less likely to act as a nidus for infection. Therefore, we recommend using monofilament sutures for SSF. Early recognition through imaging and prompt surgical management are crucial to achieving good outcomes. Research into suture material to achieve the best outcome is warranted.
