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Vaginal Mesh Complications: Treatment of Recurrent Urinary Tract Infections (UTI)
Recurrent urinary tract or bladder infections are a risk following any surgery for incontinence or prolapse, whether mesh is used or not. Women that may not be prone to infections may still be at risk for them following surgery for the first 6 to 12 months. This does not mean anything is wrong and typically these resolve after healing is complete. We don’t know exactly why this occurs, but any surgery on and around the bladder as well as using a catheter, etc is known to cause this is some women. Treatment usually is just a course of antibiotics and checking a urine culture to ensure that the correct antibiotic is being used.
If the infections are persistent, resistant to treatment with antibiotics, or the patient also has signs of urinary obstruction or incomplete emptying as mentioned in the urinary symptoms section , the surgeon needs to be sure that the sling or mesh is not too tight as this is also known to cause recurrent bladder infections. If this is the case, the sling may need to be released or removed.
It is also important, especially if there is blood in the urine, to rule out mesh erosion (as in urinary symptoms section) into the bladder or urethra. This can also cause bladder infections that are recurrent and/or resistant to treatment. Office cystoscopy should be used to look in the bladder and urethra to ensure this is not the case. If it is present, the mesh will need to be removed (see mesh erosion section).