caa a22 4500 445309997 CHVBK 20180317142626.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00404-010-1763-z doi (NATIONALLICENCE)springer-10.1007/s00404-010-1763-z Prospective evaluation of combined local bupivacaine and steroid injections for the management of chronic vaginal and perineal pain [Elektronische Daten] [Stergios Doumouchtsis, Vincent Boama, Mahalakshmi Gorti, Safwat Tosson, Michelle Fynes] Purpose: Vaginal/perineal pain is common following obstetric trauma or vaginal surgery for prolapse and may have a serious impact on sexual function and quality of life. Local injections of corticosteroids, local anaesthetic and hyaluronidase are treatment options for chronic pain; however, there are no published studies to support their efficacy. The objective of this study was to evaluate prospectively the efficacy of perineal/vaginal injections for chronic localised pain following childbirth or vaginal surgery. Methods: Consecutive women with chronic vaginal/perineal pain were recruited in this prospective series (audit). Pain severity and sexual function were determined using a visual analogue scale (VAS 0-10) and the abbreviated sexual function questionnaire (ASFQ) respectively. Patients underwent local injections with a combination of 0.5% bupivacaine (10ml), hydrocortisone (100mg) and hyaluronidase (1,500IU). Follow-up was undertaken at four-weekly intervals. Further injections were performed as clinically indicated. Results: Fifty-three women underwent ≥1 injections [mean: 1.86 (range: 1-4)]. Mean interval from index childbirth [43/53 (81%)] or surgical intervention [10/53 (19%)] was 8months (range 12weeks-20years). Twenty-seven women (51%) were sexually active. All reported dyspareunia. Fifteen (28%) women required 1 and 31(59%) two injections. Pre treatment VAS pain scores were 6.1 versus 4.1 after first injection (p=0.0002, 95% CI 1.01-3.05) and mean ASFQ scores increased from 18.1 to 29.1 (p=0.01, 95% CI −17.2 to −2.3) 4weeks post-injection. There were no adverse events or morbidity. 24/27 (89%) sexually active women with dyspareunia resolved and 18/26 (69%) sexually inactive women resumed satisfactory sexual activity 8weeks post-injection. Conclusion: In our series, this treatment was well tolerated and significant improvements in pain scores and sexual function were observed. Springer-Verlag, 2010 Perineal injection nationallicence Perineal pain nationallicence Bupivacaine nationallicence Hydrocortisone nationallicence Sexual function nationallicence Management nationallicence Doumouchtsis Stergios Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut Boama Vincent Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut Gorti Mahalakshmi Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut Tosson Safwat Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut Fynes Michelle Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut Archives of Gynecology and Obstetrics Springer-Verlag 284/3(2011-09-01), 681-685 0932-0067 284:3<681 2011 284 404 https://doi.org/10.1007/s00404-010-1763-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1763-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Doumouchtsis Stergios Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut NATIONALLICENCE 700 1- Boama Vincent Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut NATIONALLICENCE 700 1- Gorti Mahalakshmi Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut NATIONALLICENCE 700 1- Tosson Safwat Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut NATIONALLICENCE 700 1- Fynes Michelle Department of Pelvic Reconstructive Surgery and Urogynaecology, St George's Hospital, 4th Floor Lanesborough Wing, Blackshaw Road, SW17 0QT, London, UK aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/3(2011-09-01), 681-685 0932-0067 284:3<681 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer