How does vaginal reconstructive surgery impact pain and functional activity?

This study investigated if pain and functional activity (FA) is affected by vaginal reconstructive surgery (VRS).

They found that pain and FA improves for up to 2 years. 

Pelvic organ prolapse (POP) is a condition that affects many women. It can lead to urinary incontinence (UI). UI is the term for an inability to control urination. UI can have a negative effect on quality of life. Vaginal reconstructive surgery (VRS) is a treatment option for POP. This can be done using a synthetic mesh or the patient’s own tissue. There are two surgical approaches. One is called sacrospinous ligament fixation (SSLF). The second is uterosacral ligament suspension (ULS). 

The effect of SSLF or ULS on pain and functional activity (FA) is unclear. Some studies suggest that pain is observed for a short period after surgery. It is unclear if the VRS procedures have an effect on long-term pain and FA.

This study included 374 women with POP. 186 women underwent ULS. 188 women underwent SSLF. Patients were also assigned to either muscle therapy or usual care. Pain and FA were measured using standardized scales. These outcomes were measured for up to 2 years after surgery.

Pain was slightly increased at 2 weeks after surgery. Pain and FA improved compared to before surgery by 3 months after surgery. Pain during exercise was improved at 4-6 weeks and 3 months. Long-term pain and FA was significantly improved at 6, 12 and 24 months. At 2 years, the use of narcotic pain medication reduced from 14.3% to 6.8%. 

The authors concluded that pain and FA improve for up to 2 years in women who have VRS.

It is unclear if muscle therapy had an effect on the results of this study. Pain medication was self-reported so these results may be biased. 

If you have any concerns regarding UI please consult with your physician.