Vaginal packing after laparoscopic sacrocolpopexy - postoperative pain
and satisfaction: a randomized controlled trial
Abstract
Objective: Data concerning effect on early postoperative pain and
patient satisfaction after laparoscopic sacrocolpopexy (LSC) is lacking.
Design: Double-blind randomized controlled trial Setting: Tertiary
urogynaecology care centre, Faculty of Medicine in Pilsen, Charles
University Population: Women undergoing LSC for stage > 2
pelvic organ prolapse were included. The exclusion criteria were
concomitant vaginal surgery including suburethral sling or where vagina
was opened during the surgery (including hysterectomy). Women with lost
or incompletely filled-in McGill pain questionnaire were additionally
excluded from the postoperative pain and satisfaction analysis. Methods:
Women were randomized to vaginal packing after LSC with a sterile gauze.
The subjective perceptions of pain were measured using McGIll Pain
Questionnaire on day one before pack extraction and satisfaction was
assessed using VAS on postoperative day 1 and 4. Main outcome measures:
Postoperative pain on day after the surgery, patient satisfaction with
the surgery and postoperative course on day one and four. Results: In
total, 274 women were included in analysis, vaginal pack was inserted in
132 (48%) women. The groups did not differ in basic preoperative nor
surgical characteristics. Very low and comparable values of all scores
of the McGill Pain Questionnaire were observed (VAS pain 3.2 ±1.8 vs.
3.4±1.9, p=0.330). No difference in patient satisfaction on day one
(7.3±1.8 vs. 7.4±1.7, p=0.633) nor overall satisfaction on day 5
(8.7±1.3 vs. 8.8±1.1,p=0.719) was observed. Conclusion: Laparoscopic
sacrocolpopexy is associated with low levels of pain and high patient
satisfaction regardless of vaginal pack insertion. Vaginal packing does
not harm the patients. Clinical trial registration:
https://clinicaltrials.gov/study/NCT02943525