Yikes! If you’ve ever had to wait way too long to go pee, you know what a bladder infection feels like—only it feels like that all the time, even after you pee, until it is healed. If you’ve had a urinary tract infection (UTI), you know the kind of pain that ruins your life for a few days. If you have pelvic mesh, you may have one bladder infection after another and you find yourself saying, “Hey, this is a lot worse than what took me to the doctor in the first place.”
There is a whole lot of information about UTIs on the internet, but we’re talking a bit about mesh-related bladder infections today. The urinary system contains the delicate structures urine passes through—the kidneys, ureters, bladder and urethra. Put a bit of woven polypropylene (like the screen in your window) in there, and you stir up a whole mesh of trouble. For some, it’s frequent UTIs.
Causes: As we age, we lose collagen and supportive structures begin to lose elasticity, even those holding up the pelvic organs like the bladder, the uterus and the rectum. In women, the tube from the bladder to the outside (urethra) begins to change shape under the weight of those organs and bends like a paper straw causing the urine flow to slow down and sometimes stop before your bladder is empty. When some urine stays behind, your warm bladder behaves like a petri dish. Bacteria grows. The most common culprit, E. coli lives around your anus and can wander up your urethra in several ways: from wiping, from, pardon the expression, “skid marks” on your underpants, from sexual activity, especially if you wear a diaphragm, or along the side of a urinary catheter. Flushing your urinary tract by drinking water is one of the best ways to prevent and cure UTI’s.
Symptoms: Sometimes it is difficult for a woman with a pelvic mesh implant, or sling, to determine if her bladder pain is from an infection or because mesh by itself is irritating her bladder. Ordinarily, signs of a bladder infection include a frequent urge to urinate, pain and burning while urinating, increased night-time urination, lower abdominal pain, cloudy urine with a foul odor, or blood in urine. If she has mesh, she may have many of these symptoms. If the infection travels up to the kidneys, symptoms include fever, nausea, and chills as well as flank pain on either side. Kidney infections, like pyelonephritis, can become a very serious very quickly. If you have kidney symptoms, see a physician immediately.
Transvaginal mesh can become brittle and crack in the body, slicing nearby organs and may move from where it was implanted to the lower urinary tract where it can introduce infections. The sling or tape creates and ideal hiding place for bacteria, sometimes rare bacteria which is hard to treat. People who take antibiotics frequently for UTI’s are at risk of developing antibiotic-resistant bacterial infections.
Self care: You can buy a kit to test your own urine if you think you have a UTI and want to be sure. Knowing how to recognize an oncoming UTI and treating it conservatively can help you avoid the use of repeated antibiotics.
Flushing is your first line of defense. “The solution to pollution is dilution.” Flushing dilutes the numbers of bacteria and allows you body’s normal defenses a chance to work. Drink at least 8 glasses of water every day—not soda, fruit juice (other than cranberry) or milk of coffee—water. There is one important exception to this: If your physician put you on a strict fluid restriction because of kidney disease, please follow his/her instructions because your body handles fluids differently.
Cranberry juice is recommended because it has been proven to make an environment in your urine where bacteria can’t thrive. Putting a cup of unsweetened cranberry juice into 2 quarts of water will take care of both the flushing and infection. If you can’t tolerate the taste, pharmacies and some grocery stores sell cranberry capsules.
If your condition worsens or lingers more than a few days, it is important to see your health care provider about appropriate medications including antibiotics. UTIs when left untreated can escalate quickly and cause kidney damage or kidney failure.
Prevention: To prevent future infections, be diligent about making sure your bladder is fully empty, flush it with water all the time, wipe from front to back and, if you have fecal incontinence (those stained panties), use baby wipes or feminine cleansers to be sure you are completely clean after moving your bowels, minimize the use of catheters, and try not to take antibiotics unless it is absolutely unnecessary.
Non-bacterial UTI’s: Sutures and parts of mesh slings have been found inside the bladder after pelvic surgeries, causing crusting along the edges and stones to form and creating symptoms identical to UTI but the urine had no bacteria in it. It is often misdiagnosed as interstitial cystitis. In most cases, when the foreign material was removed, the symptoms went away.
Mesh removal: When mesh causes structural damage to the urinary tract, removal may be required, along with the appropriate organ repair.
Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.
If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, join my group, Surgical Mesh or check the list of support groups here.
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