Declas E, Verdun S, Fauconnier A, Lucot J P
Obstetrics and Gynecology Department, Saint Vincent de Paul Hospital, Groupe des hôpitaux de l'institut catholique de Lille (GHICL), Boulevard de Belfort, 59000, Lille, France.
Lille Catholic hospitals, Biostatistics Department-Delegation for Clinical Research and Innovation, Lille Catholic University, Lille, France.
Int Urogynecol J. 2023 Mar;34(3):771-775. doi: 10.1007/s00192-022-05285-4. Epub 2022 Sep 5.
Prolapse is a common condition seen in women and its therapeutical management consists first and foremost of surgery. Postoperative pain is one of the most common side effects seen after surgery. The objective of this study was to identify risk factors for postoperative pain after cystocele repair with mesh.
This is a secondary analysis of the multicenter randomized trial PROSPERE, which compared cystocele repair with mesh according to the vaginal or laparoscopic approach. The presence of postoperative pain was assessed by a pain-specific self-reported questionnaire (Questionnaire de Baudelocque). The statistical analysis is based on the Wilcoxon, Chi-squared, and Fisher's tests.
The prevalence of postoperative pain (pain persisting more than 6 months) was 39% (80 out of 205, 95% CI 32.4-46.1), with 6.3% (13 out of 205) of chronic pain reports. Preoperative pain was the only statistically significant risk factor OR = 2.32 (p = 0,007; 95% CI 1.24-4.36).
Surgeons must be careful with preoperative painful prolapse and should inform their patient of the risk of developing postoperative chronic pain.
子宫脱垂是女性常见病症，其治疗主要依靠手术。术后疼痛是手术最常见的副作用之一。本研究旨在确定使用网片进行膀胱膨出修补术后疼痛的风险因素。
这是对多中心随机试验PROSPERE的二次分析，该试验根据阴道或腹腔镜入路比较了使用网片进行膀胱膨出修补的情况。术后疼痛情况通过特定疼痛的自我报告问卷（Baudelocque问卷）进行评估。统计分析基于Wilcoxon检验、卡方检验和Fisher检验。
术后疼痛（疼痛持续超过6个月）的发生率为39%（205例中有80例，95%置信区间32.4 - 46.1），慢性疼痛报告占6.3%（205例中有13例）。术前疼痛是唯一具有统计学意义的风险因素，比值比 = 2.32（p = 0.007；95%置信区间1.24 - 4.36）。
外科医生必须谨慎对待术前疼痛性脱垂情况，并应告知患者术后发生慢性疼痛的风险。
