The Role of Chronic Mesh Infection in Delayed-Onset Vaginal Mesh Complications or Recurrent Urinary Tract Infections

Abstract

In this large cohort of patients with mesh removed for a diverse array of complications, cultures of the explanted vaginal mesh demonstrate frequent low-density bacterial colonization. We found no differences in culture results from women with delayed-onset pain versus acute pain, vaginal mesh extrusions versus no extrusions, or recurrent UTIs using standard culture methods. Chronic prosthetic infections in other areas of medicine are associated with bacterial biofilms, which are resistant to typical culture techniques. Further studies using culture-independent methods are needed to investigate the potential role of chronic bacterial infections in delayed vaginal mesh complications.

Prevalence and risk factors for urinary tract infection following stress urinary incontinence surgery with two midurethral sling procedures

“…Prevalence rates of UTI at 1 year after surgery in the present study were 20.9% for the TVT‐obturator group and 23.3% for the TVT‐abbrevo group. These rates were lower than those previously reported for UTI after midurethral sling procedures . No episodes of bladder injury occurred during the present study period and approximately 90% of the participants were satisfied with the surgical results.…”

“…Previous studies suggest that UTI is a much more common and troublesome adverse events following midurethral sling procedures than groin pain (20%–30% vs 1%–12%, respectively); however, UTI has been scarcely studied. The present study found no difference in rates of long‐term postoperative UTI between the two groups.…”

“…This situation, in turn, might cause urinary stasis and an increased risk of sporadic, recurrent, or complicated urinary tract infections (UTIs). Infections can also result from mild erosion of the mesh and bacterial colonization in an area proximal to the urethral meatus . Rates of UTI after midurethral sling placement are reported to be as high as 34% within the first 3 months of surgery, and up to 50% after 1 year .…”

“…Infections can also result from mild erosion of the mesh and bacterial colonization in an area proximal to the urethral meatus. 4 Rates of UTI after midurethral sling placement are reported to be as high as 34% within the first 3 months of surgery, and up to 50% after 1 year. 5,6 By contrast, an Israeli study observed a UTI rate of 21% in the first year of the postoperative period.…”

Prevention, diagnosis, and management of midurethral mesh sling complications

“…New areas of research are being explored, including the possibility that pain is associated with infection of the mesh. 30 Patient concern/anxiety surrounding surgical mesh An unconventional postoperative "complication" that we have noted in our practice is the presentation of patients with postoperative anxiety regarding surgical mesh. Despite extensive efforts at providing informed consent preoperatively, some patients become uneasy with the use of surgical mesh and wish to have it removed.…”