Local anesthesia with sedation for transvaginal correction of advanced genital prolapse

Objective The purpose of this study was to evaluate local anesthesia with sedation for vaginal surgery for advanced genital prolapse. Study design Five sacrospinous ligament suspensions and 12 vaginal paravaginal defect repairs performed under local anesthesia in 2004 were identified. Medical records and patient satisfaction questionnaire were reviewed. Patient demographics, degree of prolapse, duration of surgery, hospital stay, and responses to an anesthesia satisfaction questionnaires were recorded. Results All repairs incorporated placement of dermal allograft. Concomitant procedures included: 6 tension-free vaginal tape (TVTs), 12 posterior and 4 enterocele repairs. Mean patient age was 66.1 years. All patients had prolapse of apex or anterior wall ≥ grade 3. Mean OR time was 132 minutes. Average hospital stay was 1.2 days. No patient was converted to general anesthesia. All 17 patients were “very satisfied” with their surgical experience. Conclusion Local anesthesia with sedation can be successfully employed for most vaginal reconstructive surgeries with advanced genital prolapse. Patients report a high level of satisfaction.