A novel posterior approach using coated titanized polypropylene mesh repair for sacrococcygeal hernia: A case report and review of the literature

Abstract

Sacrococcygeal hernia is a rare complication that may occur following coccygectomy or sacrococcygeal resection. Due to its rarity, optimal management strategies remain unclear, and only a few cases have been reported in the literature. We report a case of a 70-year-old female patient who developed a large sacrococcygeal hernia following en bloc sacral coccygectomy performed for a sacral chordoma. Six months after surgery, the patient presented with a progressively enlarging posterior sacral swelling associated with constipation and difficulty in ambulation. Magnetic resonance imaging demonstrated herniation of small bowel loops and sigmoid colon through the postoperative sacral defect. The patient underwent successful repair through a posterior sacral approach using a coated titanized polypropylene mesh placed in a bridging fashion. The postoperative recovery was uneventful, and the patient was discharged on the eighth postoperative day. Sacrococcygeal hernia remains a rare surgical entity with limited evidence guiding management. This case demonstrates that posterior approach repair using coated titanized polypropylene mesh is a feasible and effective technique for managing large sacrococcygeal defects while avoiding the morbidity associated with laparotomy.