Stress Urinary Incontinence Clinical Trial
Official title:
Injection of 0.125% Marcaine During Mid-Urethral Sling Placement for Pain Relief: A Randomized Control Trial
There are many ways to perform a suprapubic approach pubovaginal sling. Some surgeons inject local pain medical into the retropubic space before placing the sling, others do not. This study is to determine if injection of local pain medication into the retropubic space before placing a mid-urethral sling for urinary stress incontinence results in lower postoperative pain scores, lower use of postoperative narcotic medication and lower rates of urinary retention.
To evaluate if an injection in the retropubic space with a local acting anesthetic,
Marcaine, (bupivacaine) at the time of mid-urethral sling placement will improve patients'
reported post operative pain and decrease the use of narcotic pain medication. This study
will include all female patients age 18 and older who will undergo a mid-urethral sling with
or without anterior repair for the treatment of urinary stress incontinence by a member of
the Division of Urogynecology and Reconstructive Pelvic Surgery who consent to be in the
study.
Once patients have consented to participate in the study they will be randomized into two
groups. One group will have the mid-urethral sling placed in the usual fashion with no
injection of local anesthetic. The other group will have the mid-urethral sling placed after
the retropubic space has been infiltrated with local anesthetic as previously described in
the literature. Pain will be assessed with the use of a Visual Analog Scale during the
hospitalization and the use of narcotic pain medication will be assessed during recovery and
overnight in the hospital. Patients will be asked to record how often and what type of pain
medication they use. Patients will also be asked to keep a log of their urination if they
are discharged home with self catheterization. They will be asked to mail in their pain
medication log and voiding diary (if needed) at a two-week post-operative. Outcomes will
then be compared.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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