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What causes mild fever and pain after bladder mesh removal and cystocele repair?

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Posted on Thu, 21 May 2015
Question: I'm 2 weeks post op from removal of TVMesh sling and repair of cystocele. I just started haing pain with a low grade fever 99-99.8, and the vaginal wall protrudes now exposing the dissolving sutures and a lot of yellow slough. I can feel the sutures poking inside me. I was placed on Cipro and seemed to get some relief after only two doses, and with pain medication. The swelling and protruding of the vaginal incision has decreased somewhat but I can still see it and I am unable to even sit for too long. Has the incision dehiscenced? Or is part of the healing process? I seems to be healing fine with no complaints until this happened two days ago. I am religious to my post op instructions to the point that I have been prone almost two weeks now.
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Answered by Dr. Aarti Abraham (41 minutes later)
Brief Answer:
Mild infection seems likely, worried about you seeing the sutures though

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Mild pain and low grade fever signifies a possible minor infection / post operative inflammation.
That would explain the response to Cipro ( antibiotic ).
SO continue the entire course, and I think the pain, fever and the swelling should subside.
Actually you should NOT be able to see the sutures,if you are able to do that, that means it is possible that the incision dehiscenced or the repair failed.
Poking sensation is common as the sutures take some time to get absorbed.
Are you trying to look inside, or are the sutures visible outside the vulva ??
Looking forward to hearing from you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Aarti Abraham (45 minutes later)
I am able to identify at least one or two sutures are within the vulva, more so when standing, but not protruding past it. My concern is the large amount of yellow sloughy material that is more visible. It is defintely not a defined suture line. It is hard and mostly yellow and the width that I am able to visualize is close to about 5mm, I am not able to see the total length. Is it dehiscing? I have litle if no white discharge with slight malodor which is decreasing since the Cipro.
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Brief Answer:
Slough is normal at this time.

Detailed Answer:
Okay, if they are not protruding, mostly it has not dehisced yet.
Slough is normal as the sutures start to heal off.
As long as there is no noticeable discharge with odour, then there is no cause for concern.
5mm is too small an area to be able to see anything clearly, it could be mostly slough.
Have you had a follow up visit yet ?
If not, one is essential to know if the dehiscence has occurred.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6010 Questions

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What causes mild fever and pain after bladder mesh removal and cystocele repair?

Brief Answer: Mild infection seems likely, worried about you seeing the sutures though Detailed Answer: Hello Thanks for writing to us with your health concern. Mild pain and low grade fever signifies a possible minor infection / post operative inflammation. That would explain the response to Cipro ( antibiotic ). SO continue the entire course, and I think the pain, fever and the swelling should subside. Actually you should NOT be able to see the sutures,if you are able to do that, that means it is possible that the incision dehiscenced or the repair failed. Poking sensation is common as the sutures take some time to get absorbed. Are you trying to look inside, or are the sutures visible outside the vulva ?? Looking forward to hearing from you.