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).

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00404-024-07533-yDOI Listing

Publication Analysis

Top Keywords

trans-obturator tension-free
12
tension-free vaginal
12
bupivacaine injection
8
vaginal tape
8
groin pain
8
pain scores
8
injection side
8
injection
6
pain
5
intra-obturator bupivacaine
4

Similar Publications

Article Synopsis
  • * A comprehensive search across multiple databases identified 13 high-quality randomized controlled trials to assess cure rates and complications associated with both surgical methods.
  • * Results showed that both TVT and TVT-O had similar mid- to long-term cure rates for SUI, but TVT was linked to a higher risk of hematoma and a lower risk of thigh/groin pain compared to TVT-O.
View Article and Find Full Text PDF

Midurethral sling infectious complications: A systematic review.

Fr J Urol

November 2024

Department of Obstetrics, Gynecology and Reproductive Medicine, Nantes University Hospital, 38, boulevard Jean-Monnet, 44000 Nantes, France. Electronic address:

Background: The French Health Authority (Haute Autorité de santé) and French scientific societies (Collège national des gynécologues et obstétriciens français) recommend the use of midurethral slings as the surgical treatment of choice for stress incontinence due to urethral hypermobility and failure of hygienic diet and pelvic rehabilitation. Within a year of implantation, almost 90% of patients no longer experience stress urinary incontinence. Despite their recognized efficacy, retropubic and/or trans-obturator midurethral sling can expose patients to potentially severe infectious complications.

View Article and Find Full Text PDF

Objective: Meta-analysis was conducted to compare and evaluate the efficacy and safety of tension-free vaginal tape (TVT), outside-in trans-obturator tape (TOT), inside-out tension-free vaginal tape-obturator (TVT-O) and transvaginal tension-free urethral sling surgery (TVT-S) in the treatment of female stress urinary incontinence (SUI).

Methods: A computer-based systematic search of the PubMed, The Cochrane Library, Medline, Embase, Web of Science and ScienceDirect databases for randomised controlled trials (RCTs) comparing TVT, TOT, TVT-O and TVT-S for the treatment of SUI was performed from the time of library construction to November 2023. Two investigators performed data extraction and quality evaluation of the included RCTs, extracting information including the follows: First author, time of publication, intervention, sample size, age, duration of follow-up and objective cure rate, subjective cure rate, dyspareunia, vaginal mucosal perforation, urinary tract infection, sling exposure and postoperative thigh pain/groin pain.

View Article and Find Full Text PDF

No mess with mesh; vaginal natural orifice transluminal endoscopic surgery (vNOTES) autologous posterior rectus fascia mesh for vaginal urinary incontinence procedures.

J Gynecol Obstet Hum Reprod

October 2024

Department of Obstetrics and Gynecology, Helsingborg, Sweden; Institution of Clinical Sciences, Dept. of Obstetrics and Gynecology, Lund University, Lund, Sweden. Electronic address:

Urinary incontinence affects 25-45 % of women with the gold standard surgical approach being placement of mid-urethral synthetic slings; tension-free vaginal tape (TVT) and trans-obturator tape (TOT). Due to the controversies regarding vaginal mesh the last decade, an increasing demand has evolved for incontinence treatment without vaginal synthetic mesh. The short term results of autologous rectus fascia sling for TOT surgery have shown similar success rates compared to those after the use of synthetic mesh, but the harvesting of the mesh is less minimally invasive and is associated with longer surgical time.

View Article and Find Full Text PDF

Objective: To compare needleless mini-slings placed in a retropubic (U-shape) or trans-obturator (hammock-shape) configuration for treating stress urinary incontinence at 60th month.

Methods: All surgeries, conducted by a senior surgeon, involved objective and subjective assessments preoperatively and at 6, 12, 18, and 60 months postoperatively using cough-stress tests, ICIQ-SF, PGI-I, and a Likert scale.

Results: After 60 months, no significant differences were found in cure rates, mesh complications, or reinterventions between U-shaped and hammock-shaped groups.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!