Int Urogynecol J (2008) 19:1311–1313 there are no cases found describing myositis as a complication of other surgical repair of pelvic organ prolapse. There is one case known with a late onset infection after a sacrospinous ligament fixation; it describes a patient who presented with an ischiorectal abscess 9 months after the procedure treated with incision and draining and with removal of the suture [6]. The overall complication rate for sacrospinous ligament fixation with or without uterine preservation or for vaginal vault prolapse described is 6.8%–29.0% depending on the study design and mean age of the study group [1, 3, 4, 7, 8]. Major intraoperative complications during sacrospinous ligament fixation are relatively uncommon; rectal injury occurs in 0.6%–1.7% of the patients during the procedure, and 0.3%–4.2% of the patients needed blood transfusion during or post-operative [1, 5, 7]. More common complications are post-operative urinary tract infection (4.5%–12.7%) and post-operative buttock discomfort, described in 2.5%–7.5% of the patients [1, 2, 4, 5, 7]. Other post-operative complications described are vault haematoma (2.5%–6.3%), thromboembolism (0.5–2.1%) and voiding dysfunction (2.8%–8.3%) [1, 4, 5, 7]. In addition, nerve injury and febrile morbidity is described. One study about the safety and quality of life after bilateral SSLF described that the peri-operative complica- tion occurred during surgery; not all occurred during the SSLF itself but as concomitant prolapse surgery [8]. This indicates that possibly some of the complications occurring during a sacrospinous ligament fixation with or without uterine preservation and pelvic floor repair are caused not during the ligament fixation itself but during one of the other procedures. Hefni et al. [1] found that the patients who underwent sacrospinous ligament fixation with uterine preservation had significant less complications than the patients who underwent sacrospinous fixation with a hysterectomy (11.5% vs 31.2%). This case presents a patient with a very rare but serious complication 1 year after she underwent a sacrospinous 1313 ligament fixation with uterine preservation. The overall major complication rate of sacrospinous ligament fixation with or without uterine preservation and pelvic floor repairment is relatively low. Nevertheless, major complica- tions are described and should always be discussed with the patient pre-operative. Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which per- mits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. References 1. Hefni M, El-Toukhy T, Bhaumik J, Katsimanis E (2003) Sacrospi- nous cervicocolpopexy with uterine conservation for uterovaginal prolapse in elderly women: an evolving concept. Am J Obstet Gynecol 188(3):645–650 2. Dietz V, de Jong J, Huisman M, Koops SS, Heintz P, van der Vaart H (2007) The effectiveness of the sacrospinous hysteropexy for the primary treatment of uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 18:1271–1276 3. van Brummen HJ, van de Pol G, Aalders CI, Heintz AP, van der Vaart CH (2003) Sacrospinous hysteropexy compared to vaginal hysterec- tomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms. Int Urogynecol J Pelvic Floor Dysfunct 14(5): 350–355 4. Lantzsch T, Goepel C, Wolter M, Koelbl H, Methfessel HD (2001) Sacrospinous ligament fixation for vaginal vault prolapse. Arch Gynecol Obstet 265(1):21–25 5. Demirci F, Ozdemir I, Somunkiran A, Topuz S, Iyibozkurt C, Duras Doyran G, Kemik Gul O, Gul B (2006) Perioperative complications in abdominal sacrocolpopexy and vaginal sacrospi- nous ligament fixation procedures. Int Urogynecol J Pelvic Floor Dysfunct 18(3):257–261 6. Hibner M, Cornella JL, Magrina JF, Heppell JP (2005) Ischiorectal abscess after sacrospinous ligament suspension. Am J Obstet Gynecol 193(5):1740–1742 7. Hefni MA, El-Toukhy TA (2006) Long-term outcome of vaginal sacrospinous colpopexy for marked uterovaginal and vault pro- lapse. Eur J Obstet Gynecol Reprod Biol 127(2):257–263 8. David-Montefiore E, Barranger E, Dubernard G, Nizard V, Antoine JM, Darai E (2007) Functional results and quality-of-life after bilateral sacrospinous ligament fixation for genital prolapse. Eur J Obstet Gynecol Reprod Biol 32(2):209–213