Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05264194 |
Other study ID # |
12411 |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
October 10, 2020 |
Est. completion date |
January 9, 2023 |
Study information
Verified date |
June 2023 |
Source |
University of Oklahoma |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Perineorrhaphy, sometimes referred to as perineoplasty, is a common procedure in pelvic
reconstructive surgery that entails surgical repair of the perineum. Indications may include:
prevention of recurrent prolapse, treatment of pain, and improved sexual function and
cosmesis, as well as to treat the sensation of a "wide vagina." Differences in postoperative
pain by suturing technique and standard use of suture type are not well established. Patient
satisfaction can be influenced by patient perceptions regarding postoperative pain, therefore
reducing postoperative pain scores remains a priority. It is unclear whether suturing
technique is associated with less pain after this procedure. Based on studies on repair of
obstetric lacerations, we hypothesize that a subcuticular skin closure will be associated
with less postoperative perineal pain compared to interrupted transcutaneous sutures.
Description:
Recruitment will be carried out at OU Medical Center within a 12-month period either at OU
Women's Pelvic and Bladder Health Clinic or OU Women's Health Clinic. Women who are planning
pelvic organ prolapse repair and who are found to have genital hiatus of ≥4 cm on the pelvic
organ prolapse quantification exam will be approached for study inclusion. A 4-cm or greater
dimension of genital hiatus is associated with greater risk of prolapse recurrence, and
researchers anticipate patients with this measurement prior to surgery will require a
perineorrhaphy. These surgeries will be performed by one of two board certified female pelvic
medicine and reconstructive surgery specialists. Given the nature of the suturing techniques,
it would be impossible to blind the study to both the investigators and the participants.
Randomization will be completed prior to the procedure and contained within opaque sealed
envelopes until a decision is made to proceed with a perineorrhaphy intraoperatively.
To standardize the procedure, an instructional video will be made to describe the
subcuticular and transcutaneous interrupted techniques. This will serve as reference for
investigators to adhere to the standard procedure. An educational webinar will be performed
at the onset of the study and this instructional video will be available for review at any
additional point during the study. Participants will be asked to complete a baseline SPS
questionnaire prior to surgery. Perineorrhaphy will be carried out in our standard fashion
and finalized with interrupted stitches of delayed absorbable monofilament sutures for
reconstruction of the perineal body. The perineal skin closure will be randomized to
continuous subcuticular or interrupted transcutaneous stitches of 3-0 polyglactin-910
(Vicryl). Researchers will follow the standard Enhanced Recovery After Anesthesia (ERAS)
protocol for postoperative oral analgesia. Participants will be asked to complete daily SPS
questionnaires in the first two weeks postoperatively. Patients are routinely scheduled for a
2- week and 3- month postoperative visit. Participants will complete a questionnaire to
assess pain (SPS) and patient satisfaction at both visits. A pelvic exam is not routinely
performed at the 2-week visit unless indicated otherwise by patient or provider concerns. At
the 3-month postoperative visit, a sexual function questionnaire and a pelvic exam will be
completed in addition to the pain and patient satisfaction survey. These surveys can be
administered in person or remotely (by telephone or virtually), depending on the nature of
the postoperative visits.