Comparing outcomes following pelvic floor reconstructive surgery for the use of vaginal packing soaked with either estrogen, bupivacaine or saline
Determine if there is any difference in outcomes between estrogen, bupivacaine and saline-soaked vaginal packing, in patients following pelvic floor reconstructive surgery.
●The primary outcome is post-operative pain, as rated by patients using a visual analog scale (VAS) at 2 and 6 hours post-surgery and on the morning of POD#1. ●Secondary outcomes include: intra-operative estimated blood loss (EBL), change in hemoglobin, urinary retention (as measured by trial of void), and length of stay (LOS) in hospital.
If saline-soaked vaginal packing is shown to be non-inferior in post-operative outcomes, it may become the least expensive choice for patients undergoing vaginal surgery.
Figure 1. a)There were no significant differences in EBL between subjects in the different treatment groups (p=0.89). EBL was recorded as 0-9, corresponding to volume of blood lost (cc) indicated in the table above. b)There were no significant differences in change in hemoglobin between subjects in the different groups (p=0.68). c)Trial of void was recorded as 1 for yes and 0 for no. There were no significant differences between treatment groups (p=0.45). d)There were no significant differences in length of hospital stay between subjects in different treatment groups (p=0.97). Data is displayed as mean ± SD.
Figure 2.There were no significant differences between any of the three treatment methods onVAS scores at 2 hours, 6 hours, and 1 day post-surgery. Data is displayed as mean ± SD.
This study did not find a difference between the use of estrogen cream, bupivacaine, and saline with vaginal packing after pelvic floor reconstructive surgery on post-operative VAS pain scores, EBL, change in hemoglobin, urinary retention, or LOS. Saline soaked packing is an equivalent, but less expensive, alternative to estrogen or bupivacaine vaginal packing.