Post-colpocleisis pyocolpos: Three case reports.

Colpocleisis is a procedure to safely manage advanced pelvic organ prolapse, particularly in older individuals and those who are medically compromised. An exceptionally uncommon and underreported infection-related complication following colpocleisis is postoperative pelvic abscess. This case series describes the clinical presentation and diagnostic challenges, along with the management approaches of this unusual complication. Three women in their early 70s, with prior comorbidities, developed pelvic abscesses 10-15 days after colpocleisis. All three presented with systemic inflammatory signs, including fever, leukocytosis, and elevated inflammatory markers. One of the women also developed a concurrent urinary tract infection. Diagnosis was confirmed by transperineal ultrasonography and contrast-enhanced computed tomography. Management involved surgical drainage through colpotomy with reopening of the obliterated vaginal canal. Purulent material was thoroughly evacuated. Cultures of abscesses revealed polymicrobial infections in all cases. One patient with septic shock had an additional positive bloodstream culture. Pyocolpos is an uncommon yet serious infectious complication following colpocleisis that is more commonly observed as a consequence of post-hysterectomy vaginal cuff hematoma. Clinicians should be extremely cautious when examining postoperative febrile patients, even when common illnesses such as urinary tract infections are present. In this case series, surgical drainage and tailored antibiotic therapy resulted in full remission of all three patients without compromising prolapse repair or triggering recurrence. Future studies are required to guide the best course of management.