Corresponding author:
prof. Zdenek Rusavy, M.D., Ph.D.
Department of Gynaecology and Obstetrics, Faculty of Medicine in Pilsen, Charles University
Alej Svobody 80, 323 00, Pilsen, Czech Republic
Email: rusavyz@fnplzen.cz
Running title: Vaginal Packing After Sacrocolpopexy: Pain and Satisfaction
Previous presentation: The data was previously presented at the 16th EUGA Annual Meeting in Varese 19 - 21. October 2023
Funding: This work was funded by Charles University, Cooperatio Program, research area Maternal and Childhood Care. The funders did not have a role in the collection, analysis and interpretation of data and in the writing of the manuscript
Author disclosure/conflict of interest: The authors declare no conflicts of interests.
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
Keywords: Prolapse, Pelvic Organ Prolapse, Sacrocolpopexy, Vaginal packing, Satisfaction