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Postoperative pain and the need for intervention after sacrospinous ligament hysteropexy compared to colpopexy: a retrospective cohort study

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Abstract

Objectives

To compare postoperative pain between patients undergoing sacrospinous ligament colpopexy (SSLF) and hysteropexy (SSLH).

Methods

This was a retrospective cohort study of all patients undergoing native tissue SSLF and SSLH between January 2013 and March 2020. The electronic medical record was queried for demographic and perioperative data until the postoperative visit. The primary outcome was a composite incidence of any of the following: telephone calls, urgent office visits, additional analgesic prescriptions and need for intervention for pain in the buttocks, posterior thigh or perirectal area. Secondary outcomes were the incidence of persistent pain at the postoperative visit and perioperative risk factors associated with reported pain.

Results

A total of 406 patients met inclusion criteria (308 SSLF, 98 SSLH). The composite pain outcome was seen in 99 patients (24.4%; 95% CI 20.5%–28.8%), and there was no statistical difference between cohorts. Persistent pain was seen in 15.6% and 13.3% of SSLF and SSLH patients at 6 weeks (p = 0.58). Twelve patients (3.0%) underwent interventions for pain, including physical therapy (2), trigger point injections (5) and suture release (5). Compared to SSLF patients, SSLH patients were more likely to need interventions (7 [7.1%] vs. 5 [1.6%], p = 0.005) and office visits (14 [14.3%] vs. 13 [4.2%], p = 0.0005) for pain.

Conclusions

There was no difference in the overall incidence of postoperative pain between patients who underwent SSLF or SSLH. However, patients who underwent hysteropexy were more likely to need intervention and office evaluation for postoperative pain.

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References

  1. Randall CL, Nichols DH. Surgical treatment of vaginal inversion. Obstet Gynecol. 1971;38:327–32.

    CAS  PubMed  Google Scholar 

  2. Dietz V, Huisman M, de Jong JM, et al. Functional outcome after sacrospinous hysteropexy for uterine descensus. Int Urogynecol J. 2008;19:747–52.

    Article  Google Scholar 

  3. Detollenaere RJ, den Boon J, Stekelenburg J, IntHout J, Vierhout ME, Kluivers KB, et al. Sacrospinous hysteropexy versus vaginal hysterectomy with suspension of the uterosacral ligaments in women with uterine prolapse stage 2 or higher: multicentre randomised non-inferiority trial. BMJ. 2015;351:h3717. https://doi.org/10.1136/bmj.h3717.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hefni M, El-Toukhy T, Bhaumik J, Katsimanis E. Sacrospinous cervicocolpopexy with uterine conservation for uterovaginal prolapse in elderly women: an evolving concept. Am J Obstet Gynecol. 2003;188(3):645–50. https://doi.org/10.1067/mob.2003.75.

    Article  CAS  PubMed  Google Scholar 

  5. Maher CF, Cary MP, Slack MC, et al. Uterine preservation or hysterectomy at sacrospinous colpopexy for uterovaginal prolapse? Int Urogynecol J. 2001;12:381–5.

    Article  CAS  Google Scholar 

  6. Meriwether K, Antosh D, Olivera C, et al. Uterine preservation vs hysterectomy in pelvic organ prolapse surgery: a systematic review with meta-analysis and clinical practice guidelines. Am J Obstet Gynecol. 2018;219(2):129–146.e2.

    Article  Google Scholar 

  7. Lovatsis D, Drutz HP. Safety and efficacy of sacrospinous vault suspension. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(5):308–13.

    Article  CAS  Google Scholar 

  8. Unger CA, Walters MD. Gluteal and posterior thigh pain in the postoperative period and the need for intervention after sacrospinous ligament colpopexy. Female Pelvic Med Reconstr Surg. 2014;20(4):208–11.

    Article  Google Scholar 

  9. Mowat A, Wong V, Goh J, et al. A descriptive study on the efficacy and complications of the Capio (Boston Scientific) suturing device for sacrospinous ligament fixation. Aust N Z J Obstet Gynaecol. 2018;58(1):119–24.

    Article  Google Scholar 

  10. Roshanravan SM, Wieslander CK, Schaffer JI, et al. Neurovascular anatomy of the sacrospinous ligament region in female cadavers: Implications in sacrospinous ligament fixation. Am J Obstet Gynecol. 2007;197:660.e1–6.

    Article  Google Scholar 

  11. Wallner C. Buttock pain after sacrospinous hysteropexy. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1729–30 author reply 1731.

    Article  Google Scholar 

  12. Florian-Rodriguez ME, Hare A, Chin K, Phelan JN, Ripperda CM, Corton MM. Inferior gluteal and other nerves associated with sacrospinous ligament: a cadaver study. Am J Obstet Gynecol. 2016;215(5):646.e1–6.

    Article  Google Scholar 

  13. Arendt-Nielsen L, Madsen H, Jarrell J, Gregersen H, Drewes AM. Pain evoked by distension of the uterine cervix in women with dysmenorrhea: evidence for central sensitization. Acta Obstet Gynecol Scand. 2014;93(8):741–8.

    Article  Google Scholar 

  14. Origoni M, Leone Roberti Maggiore U, Salvatore S, Candiani M. Neurobiological mechanisms of pelvic pain. Biomed Res Int. 2014;2014:903848.

    Article  Google Scholar 

  15. Pinto PR, McIntyre T, Almeida A, Araújo-Soares V. The mediating role of pain catastrophizing in the relationship between presurgical anxiety and acute postsurgical pain after hysterectomy. Pain. 2012;153(1):218–26.

    Article  Google Scholar 

  16. Chan WV, Le B, Lam M, Shariff SZ, Gomes T, Lipscombe L, Murji A. Opioid prescribing practices for women undergoing elective gynecologic surgery. J Minim Invasive Gynecol. 2021;28(7):1325–1333.e3.

    Article  Google Scholar 

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Authors and Affiliations

  1. Obstetrics, Gynecology and Women’s Health Institute, Center for Urogynecology and Pelvic Reconstructive Surgery, Cleveland Clinic, 9500 Euclid Ave/A81, Cleveland, OH, 44195, USA

    Angela S. Yuan & Cecile A. Ferrando

  2. Department of Obstetrics & Gynecology, Division of Urogynecology, University of South Florida, Tampa, FL, USA

    Katie A. Propst

Authors
  1. Angela S. Yuan
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  2. Katie A. Propst
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  3. Cecile A. Ferrando
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Contributions

AS Yuan: Protocol/project development, Data collection, Data analysis, Manuscript writing/editing

KA Propst: Protocol/project development, Manuscript editing

CA Ferrando: Protocol/project development, Manuscript editing

Corresponding author

Correspondence to Angela S. Yuan.

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Conflict of interest

Dr. Ferrando and Dr. Yuan report authorship royalties from UpToDate, Inc.

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Yuan, A.S., Propst, K.A. & Ferrando, C.A. Postoperative pain and the need for intervention after sacrospinous ligament hysteropexy compared to colpopexy: a retrospective cohort study. Int Urogynecol J 33, 2525–2531 (2022). https://doi.org/10.1007/s00192-022-05301-7

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  • DOI: https://doi.org/10.1007/s00192-022-05301-7

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