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Forum Name: Gynecology

Question: constant pain and uti after rectocele and cystocele surgery


 rlm - Fri Apr 24, 2009 10:19 pm

I had vaginal hysterectomy in 8/2008 and also rectocele surgery In december of 2008 had cystcele surgery with mesh sling on uretha constant bladder infections also fell down three steps on 4/17/09 and have not had a bowel movement only bad gas please help in have stomach and lower back pain and still have discharge since first surgery thank you
 j. gregory roberts - Thu Oct 15, 2009 1:33 am

The said Sxs are somewhat convoluted, and may be related to a mesh infection, pelvic haematoma or seroma w/ posterior bladder compression. CT abd/pelvis should be paramount to assess anatomy and its "correction." Gynecologic evaluation should be strongly encouraged.
 Dr.M.Aroon kamath - Thu Oct 15, 2009 6:54 am

User avatar Hi rlm,
Weakness of the pelvic floor along with its associated complications can lead to many symptoms including urinary symptoms.Cystoceles do cause urinary symptoms (including UTI's) and are sometimes associated with urethral hypermotility, causing incontinence which perhaps, is the most debilitating urinary symptom.
The symptoms are supposed to get better following surgical repair because the deranged anatomy and disturbed physiology
is restored to normal.
In the literature (as far as my knowledge goes!), there is a paucity of studies which investigate in detail the urinary symptoms which occur following surgery for cystoceles, rectoceles etc).The reason for this could be because these procedures are a grey area (an overlapping of specialities - Obs /gyn and urology).
Failed repair is obviously one reason which can in theory, result in UTIs (as a result of more derangement in pelvic floor anatomy and consequent urinary bladder deformity).

Let me put forth some (plausible?!!) reason which is purely hypothetical!
Let us presume for a moment that the repair was 100% successful.The patient is rid of all the symptoms she had in the past, and returns to normal physical and sexual activity.
As you are well aware, there is enormous info available in the net as well as elsewhere about the "fact" that the patient can get back to routine physical and sexual activity 'very soon' etc.

Now let us presume that the patient returns to rather increased level of sexual activity (perhaps because of enhanced body image of self and increased acceptance from the sexual partner).This, in theory is capable of ending up in a situation akin to the well known "Honeymoon cystitis"!!.

I hope this explanation opens up some interesting discussion on 'Doctors Lounge'.Good luck!

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