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Archives of Gynecology and Obstetrics

14-05-2024 | Tension-Free Vaginal Tape | Urogynecology

Intra-obturator bupivacaine injection and post-operative pain following the trans-obturator tension-free vaginal tape procedure: randomized study

Authors: Vladislav Volchok, Victoria Kapustian, Ahmet Namazov, Rachel Zangen, Eyal Y. Anteby, Ofer Gemer

Published in: Archives of Gynecology and Obstetrics

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Abstract

Purpose

To assess the effectiveness of a long-acting anesthetic injection into the obturator membrane for pain relief in women undergoing trans-obturator tension-free vaginal tape.

Methods

A total of 22 women were randomized for the intra-operative injection of bupivacaine into one of their obturator membranes: the left or right side. All the participants were asked to define their groin pain on a visual analog scale (scored 0–10 cm) at 1, 6, 12, and 24 h post-operative. For each woman, pain scores were compared between the local anesthetic-injected side and the opposite side.

Results

Statistically significant differences were not observed in groin pain scores between the bupivacaine injection side and the no injection side at 1 h (p = 0.76), 6 h (p = 1), 12 h (p = 0.95), and 24 h (p = 0.82) post-operative.

Conclusion

In women who undergo trans-obturator tension-free vaginal tape procedures, intra-operative intra-obturator injection of local anesthetics is not effective in alleviating the characteristic post-operative groin pain.

Trial registration

This study is registered on ClinicalTrials.gov (NCT03479996).
Literature
1.
2.
Latthe PM, Foon R, Toozs-Hobson P (2007) Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 114:522–531CrossRefPubMed
3.
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26CrossRefPubMed
4.
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2003) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International continence society. Urology 61:37–49CrossRefPubMed
5.
Nilsson CG, Palva K, Rezapour M, Falconer C (2008) Eleven years prospective follow-up of the tension-free vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:1043–1047CrossRefPubMed
6.
Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7:81–85CrossRefPubMed
7.
Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 11:1306–1313PubMed
8.
Agur W, Riad M, Secco S, Litman H, Madhuvrata P et al (2013) Surgical treatment of recurrent stress urinary incontinence in women: a systematic review and meta-analysis of randomized controlled trials. Eur Urol 64:323–336CrossRefPubMed
9.
Laurikainen E, Valpas A, Kivelä A, Kalliola T, Rinne K, Takala T et al (2007) Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol 109:4–11CrossRefPubMed
10.
11.
Cadish LA, Hacker MR, Dodge LE, Dramitinos P, Hota LS, Elkadry EA (2010) Association of body mass index with hip and thigh pain following transobturator midurethral sling placement. Am J Obstet Gynecol 203:508.e1–5CrossRefPubMed
12.
Tamussino K, Hanzal E, Kölle D, Tammaa A, Preyer O, Umek W et al (2007) Transobturator tapes for stress urinary incontinence: results of the Austrian registry. Am J Obstet Gynecol 197(6):634CrossRef
13.
Hazewinkel MH, Hinoul P, Roovers JP (2009) Persistent groin pain following a trans-obturator sling procedure for stress urinary incontinence: a diagnostic and therapeutic challenge. Int Urogynecol J Pelvic Floor Dysfunct 20(3):363–365CrossRefPubMed
14.
de Leval J, Thomas A, Waltregny D (2011) The original versus a modified inside-out transobturator procedure: 1-year results of a prospective randomized trial. Int Urogynecol J 22(2):145–156CrossRefPubMed
15.
Duckett J, Baranowski A (2013) Pain after suburethral sling insertion for urinary stress incontinence. Int Urogynecol J 24(2):195–201CrossRefPubMed
16.
Tommaselli GA, Di Carlo C, Formisano C, Fabozzi A, Nappi C (2014) Effect of local infiltration analgesia on post-operative pain following TVT-O: a double-blind, placebo-controlled randomized study. Arch Gynecol Obstet 290(2):283–289PubMed
17.
de Leval J, Waltregny D (2005) New surgical technique for treatment of stress urinary incontinence TVT-Obturator: new developments and results. Surg Technol Int 14:212–221PubMed
18.
Cadish LA, Hacker MR, Modest AM, Rogers KJ, Dessie S (2017) Association between body mass index and pain following transobturator sling. J Obstet Gynaecol 37:766–769CrossRefPubMedPubMedCentral
19.
Giugale LE, Baranski LA, Meyn LA, Schott NJ, Emerick TD, Moalli PA (2021) Preoperative pelvic floor injections with bupivacaine and dexamethasone for pain control after vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 137:21–31CrossRefPubMed
Metadata
Title
Intra-obturator bupivacaine injection and post-operative pain following the trans-obturator tension-free vaginal tape procedure: randomized study
Authors
Vladislav Volchok
Victoria Kapustian
Ahmet Namazov
Rachel Zangen
Eyal Y. Anteby
Ofer Gemer
Publication date
14-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-024-07533-y