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Had vaginal mesh sling done. Taken antibiotics for bladder infections. Suffer pain in the tail bone. What to do?

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Practicing since : 2007
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I had a vaginal mesh sling done eight weeks ago and really didn't seem to have any more pain or problems in the first four weeks than I would have expected. I did have two different infections and did two rounds of antibiotics for bladder infections, but was told that was not uncommon. But after feeling really pretty well, at the four weeks point I started having a severe pain in two places right above my tailbone which radiated out from there on the right side and into my hip and sometimes down my right leg. This pain was always there in the two spots and the other areas would be worse when standing longer periods of time. Sitting for more than a few minutes was extremely painful and I wake up in the night with alot of pain. This all got progressively worse and I was contacting my doctor repeatedly, as I really felt like something was very wrong. He checked me at six weeks and said there was just alot of swelling but everything seemed to be doing fine. He said, in regard to the two points where the pain starts, "If you could take a drill and drill straight in from both of those points, that would be where your screws are XXXXXXX After taking hydrocodone several times a day for the pain and that still not taking care of it, I finally went in to his office and really was pretty desperate. I could understand this kind of pain right after surgery, but this had not started until about a month afterwards and it was getting worse all the time..and the pain medication wasn't taking care of it. I had done some reading and had begun to wonder if my pudendal nerve might be constricted or something to cause that pain. And, at that point, I had started having problems with my bowels and occassionally would have a bowel movement and not even know it was going to happen. That seemed to spur him to order an MRI with contrast, which he said would let him see the nerve and if anything was wrong. The MRI was done, though the techs messed up and even though the contrast was on the paperwork that I saw on the order, they did not do the contrast. When I saw the doctor the next day, he was extremely vague and said the report just showed swelling and if he had nicked the nerve or something it should have hurt right away, not start this far out from surgery. He also indicated he was nowhere near my rectum in the surgery so that shouldn't be the problem. Just wrote it all off as due to swelling, though said it was very rare and he didn't really see people who were having this problem at this point, most had it in the beginning and then it went away in several weeks or months. Told me he couldn't tell me when 'this pain' would go away...maybe 2 months, maybe 6 months, he didn't know. I realized when I was in his office that they had not given me an injection or IV for the contrast and asked him about it, as I thought that was how they were to see the nerve to tell if it was constricted...he said he would XXXXXXX with the neurologist to go over all the pictures and see what he my knowledge, that never happened. He put me on neurotin and it has helped the pain some, but I am unable to take any higher dose because it left me doing things and not knowing about it or forgetting everything and totally unsure on my feet. Anyway, last week, he referred me to an orthopedic doctor which I will see next week. He indicated maybe it is due to the position I was in during surgery for several hours...when I asked about that earlier, he said it would have occurred much earlier if that was the reason. The pain remains the same and is very painful during the night. I am a very on the go person, very upbeat and positive all the time (actually do motivational speaking and seminars at times)...these problems have left me feeling as though my doctor thinks I"m a 'problem patient' and I am very down about the constant pain with no answers.
Posted Wed, 7 Aug 2013 in General Health
Answered by Dr. Lohit K 2 hours later
Hi XXXXX thanks for using XXXXXXX

Severe pain in two places right above your tailbone which radiated out from there on the right side and into hip and sometimes down right leg. This may be due to three important causes. 1. Disc prolapse. 2. Compression of nerve. 3. Ureteric calculi. Since your pain is present always in 2 spots and the other areas are worse when standing or sitting for longer periods of time. This suggest mainly towards spinal problem. As told by your doctor if there is any injury during surgery the consequences would have shown at the same time and vaginal mesh sling does not involve spine cord or nerve.

If pudendal nerve is involved then other than positional pain and numbness, the main symptoms are fecal incontinence and urinary incontinence and the pain is typically caused by sitting, relieved by standing, and is absent when lying down or sitting on a toilet seat. But your symptoms are not relating to it.

Some times even hydrocodone causes bowel disturbances. Neurotin is gabapentin which is given for neurological pain and you have some relief so continue it. You can ask the radiologist to give a opinion on the spine, a CT scan may be required, any compression on cord or nerve or any disc prolapse. Do some stretching exercises regularly for your lower back like Straight leg raising to relieve from muscle spasms and also can take muscle relaxant like chlorzoxazone every night for a week with NSAID for pain, reduce your weight, have good control on diet(calorie intake). Take plenty of fluids. If any problem in spine like disc prolapse, nerve compression then consult your orthopedician to treat for it.
Get done complete hemogram, lipid profile, renal function test and urine routine to rule out any other cause and get back to us if any problem in report.
Hope I answered all your questions. Feel free to ask me if you have any further queries. Wish you good health. Take care.

Dr. Lohit
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