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Surgical Pain After Transobturator and Retropubic Midurethral Sling Placement.

dc.contributor.author Barber, Matthew Don
dc.contributor.author Jelovsek, John E
dc.contributor.author Siff, LN
dc.contributor.author Thomas, TN
dc.coverage.spatial United States
dc.date.accessioned 2017-08-01T15:17:23Z
dc.date.available 2017-08-01T15:17:23Z
dc.date.issued 2017-07
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/28594776
dc.identifier.uri http://hdl.handle.net/10161/15146
dc.description.abstract OBJECTIVE: To compare prevalence and severity of any surgical pain between transobturator and retropubic slings; secondary aims were to compare pain at anatomic locations, pain medication use, and pain resolution between transobturator and retropubic slings and to compare pain between types of transobturator slings. METHODS: This is a secondary analysis of the Trial of Mid-Urethral Slings, which compared retropubic and transobturator sling outcomes and included 597 participants from 2006 to 2008. Postoperative assessments included body maps, visual analog scales, Surgical Pain Scales, and medication inventories for 30 days, at 6 weeks, and 6, 12, and 24 months. Postoperative pain prevalence and severity were compared. Mixed models compared pain resolution and severity over time. Regression models compared pain prevalence and severity between types of transobturator slings. Eighty percent power was provided for the primary outcome pain prevalence and 95% power was provided for the primary outcome pain severity. RESULTS: Postoperative prevalence of any surgical pain, pain severity, and pain medication was not different between retropubic and transobturator slings. Retropubic sling was associated with greater prevalence of suprapubic pain at 2 weeks (proportion difference 10.6%; 95% confidence interval [CI] 4.6-16.4%; P<.001). Transobturator sling was associated with greater prevalence of groin pain at 2 weeks (proportion difference 12.0%; 95% CI 7.1-16.8%; P<.001). There was no difference in pain resolution (odds ratio [OR] 1.11, 95% CI 0.88-1.40; P=.38). Between types of transobturator slings, the odds of surgical pain were similar at 2 (OR 2.39, 95% CI 0.51-11.31; P=.27) and 6 weeks (OR 0.46, 95% CI 0.02-9.20; P=.61). CONCLUSION: Transobturator and retropubic slings are associated with low prevalence of any surgical pain. Transobturator sling was associated with greater prevalence of groin pain at 2 weeks, and retropubic sling was associated with greater prevalence of suprapubic pain at 2 weeks. Surgical pain resolved quickly in both groups.
dc.relation.ispartof Obstet Gynecol
dc.relation.isversionof 10.1097/AOG.0000000000002068
dc.subject Adult
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Female
dc.subject Humans
dc.subject Middle Aged
dc.subject Ohio
dc.subject Pain Measurement
dc.subject Pain, Postoperative
dc.subject Prevalence
dc.subject Suburethral Slings
dc.subject Urinary Incontinence, Stress
dc.subject Urologic Surgical Procedures
dc.title Surgical Pain After Transobturator and Retropubic Midurethral Sling Placement.
dc.type Conference
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/28594776
pubs.begin-page 118
pubs.end-page 125
pubs.issue 1
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Obstetrics and Gynecology
pubs.organisational-group Obstetrics and Gynecology, Urogynecology
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 130
dc.identifier.eissn 1873-233X


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