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