This case involves a fifty-four-year-old female patient who underwent a vaginal vault repair. She subsequently had damage to her sciatic nerve suffering from motor/sensory dysfunction with paralysis postoperatively. Additionally, she had pain and numbness in her left foot and hip. As a result, she had a second procedure in an attempt to repair the damaged sciatic nerve. It was discovered the suture anchoring the left uterine ligament transected the sciatic nerve. Unfortunately, the above symptoms continued and she walks with a limp. She also suffers from complex regional pain syndrome controlled with narcotics.
Questions to the expert and their responses
What is the likelihood of sciatic nerve damage in vaginal vault repair?
Pain, temporary urinary retention, and constipation are common in the perioperative period. Serious complications are uncommon, and include development of a hematoma, infection, inclusion cyst formation, fecal impaction, and injury to the rectum with the development of a rectovaginal or a rectoperineal fistula. Bowel and defecatory dysfunction may continue long-term, and prolapse may recur de novo dyspareunia or fecal incontinence may also occur. Utilization of mesh is associated with additional complications, such as mesh erosion, infection of the graft, and persistence of granulation tissue. Sciatic nerve transection is an extremely uncommon complication of vaginal vault repair and likely due to an inexperienced surgeon.
About the author
Michael Talve, CEO
Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.
