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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Frequent UTI's, Vaginal Pain After Bladdre Surgery With Vaginal Mesh, No Help With Antibiotics. Cure ?

I had bladder surgery with vaginalmmesh 4 years ago. In last 3 months 8 have have frequent UTI's, vaginalmpail, severe spasmodic pain on emptying bladder that do not resolve after antibiocs. Today I brought a urine to the lab that looked like pea soup. No back pain, fever, CVAT noted. But BS is high. Om Insulin sliding scale, and require more coverage. Could it be the mesh.
Thu, 12 Sep 2013
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OBGYN 's  Response
Thanks for your question. Vaginal mesh is frequently in the news and this is timely.
Vaginal mesh is made from several different sources. The most commonly used mesh is polypropylene which has been used in surgery since 1958 for hernia repairs. Polypropylene mesh used in vaginal surgery is usually preformed for use in this area.
Mesh is a foreign body so tissue reaction is always a possibility. The use of vaginal estrogen supplements after mesh surgery helps heal the vagina and keep the tissues healthy. If mesh erodes and causes pain from exposure inside the vagina, the mesh can be revised or removed in a subsequent procedure. I have not seen mesh erode into the bladder but it is possible.
Bladder infections would be likely if mesh erodes into the bladder. Vaginal pain and/or bleeding is a warning sign for mesh erosion. Blood in the urine may indicate mesh erosion or a hemorrhagic bladder infection.
You will need to see a doctor well trained in the use of vaginal mesh such as a urologist or urogynecologist. The bladder can examined in the office using a cystoscope to see if mesh is present within the bladder itself. The vagina can be inspected and palpated for vaginal mesh erosion. If erosion has occurred, further surgery may be required to correct the erosion or remove the mesh.
The fact that you are diabetic puts you at risk for poor tissue healing and infection, especially since your blood sugar is high. The mesh may react locally but not throughout your body, so is not the likely cause of difficulty with blood sugar control. However, the reverse is possible, with difficulty controlling blood sugar contributing to local reactions of the mesh around the vagina and bladder. Being seen by a urologist or urogynecologist is rather urgent in your situation.
I hope this helps answer your questions. I am available for follow up if needed.
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Frequent UTI's, Vaginal Pain After Bladdre Surgery With Vaginal Mesh, No Help With Antibiotics. Cure ?

Thanks for your question. Vaginal mesh is frequently in the news and this is timely. Vaginal mesh is made from several different sources. The most commonly used mesh is polypropylene which has been used in surgery since 1958 for hernia repairs. Polypropylene mesh used in vaginal surgery is usually preformed for use in this area. Mesh is a foreign body so tissue reaction is always a possibility. The use of vaginal estrogen supplements after mesh surgery helps heal the vagina and keep the tissues healthy. If mesh erodes and causes pain from exposure inside the vagina, the mesh can be revised or removed in a subsequent procedure. I have not seen mesh erode into the bladder but it is possible. Bladder infections would be likely if mesh erodes into the bladder. Vaginal pain and/or bleeding is a warning sign for mesh erosion. Blood in the urine may indicate mesh erosion or a hemorrhagic bladder infection. You will need to see a doctor well trained in the use of vaginal mesh such as a urologist or urogynecologist. The bladder can examined in the office using a cystoscope to see if mesh is present within the bladder itself. The vagina can be inspected and palpated for vaginal mesh erosion. If erosion has occurred, further surgery may be required to correct the erosion or remove the mesh. The fact that you are diabetic puts you at risk for poor tissue healing and infection, especially since your blood sugar is high. The mesh may react locally but not throughout your body, so is not the likely cause of difficulty with blood sugar control. However, the reverse is possible, with difficulty controlling blood sugar contributing to local reactions of the mesh around the vagina and bladder. Being seen by a urologist or urogynecologist is rather urgent in your situation. I hope this helps answer your questions. I am available for follow up if needed.