Published in:
01-01-2013 | Original Article
Low back pain does not improve with surgical treatment of pelvic organ prolapse
Published in: International Urogynecology Journal | Issue 1/2013
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Introduction and hypothesis
Our goal was to determine if there is a correlation between low back pain (LBP) and pelvic organ prolapse (POP) by assessing for change in LBP after surgical correction of prolapse.
Methods
Patients undergoing POP surgery were recruited to participate. They completed the Oswestry Disability Index (ODI), a validated back pain questionnaire, at their preoperative and postoperative visits at 1, 3, and 6 months. A higher ODI score (0–100) represents more severe disability. A 9-point change represents a minimal clinically important difference (MCID). The primary outcome was the change in ODI scores from preoperative to 3 months postoperative. We analyzed ODI scores with repeated measures analysis of variance (ANOVA). Power analysis showed that a sample size of 50 was needed for 88 % power to resolve a MCID on ODI.
Results
A total of 51 patients were recruited and 43 (84 %), 34 (67 %), and 36 (71 %) completed the 1-, 3-, and 6-month follow-up, respectively. The mean ODI scores at the preoperative and the 1-, 3-, and 6-month postoperative visits were 15, 19, 9, and 9. The mean ODI score from preoperative to 3 months postoperative improved by 5 points [confidence interval (CI) −9.2 to −0.5, p = 0.03]. Of the participants 7 (20.6 %, CI 11–35 %) experienced a MCID improvement, 24 (70.6 %, CI 56–83 %) reported no substantial change, and 3 (8.8 %, CI 3–20 %) experienced a MCID worsening.
Conclusions
Our study found a statistically significant but not clinically significant improvement of LBP after surgical repair of prolapse.