The aim of this study to investigate the effect of preoperative pain hypervigilance on postoperative pain, bladder-bowel symptoms and sexual life after vaginal surgery and to compare these parameters before and after surgery. Pain vigilance (Pain Vigilance and Awareness Questionnaire-PVAQ), pain catastrophizing (Pain Catastrophizing Scale-PCS), bladder-bowel function (Australian Pelvic Floor Questionnaire-APFQ), and sexual function (Female Sexual Function Index (FSFI)) of women were recorded before and after surgery. Visual analogue scales were used to assess the postoperative pain intensity.
Hypervigilance is the state of being consciously alert to external stimuli. Specific attention to pain or other somatosensory stimuli is defined as "specific hypervigilance". Hypervigilance is a strong indicator of subjective acute postoperative pain and contributes significantly to the prediction of post-operative pain. A cautious bias toward positive preoperative stimuli may predispose patients to postoperative pain, indicating a maladaptive coping method. Pain-related disability occurs in patients with a high level of pain hypervigilance before surgery. Urinary and bowel functions are impaired after vaginal surgery and bladder-bowel dysfunction is observed. Sexual function is also affected positively or negatively after vaginal surgery. The causes of sexual dysfunction after vaginal surgery are classified as organic, emotional and psychological. Decreased pelvic blood flow may cause vaginal dryness and dyspareunia by causing vaginal smooth muscle fibrosis. This study was planned to evaluate the effect of preoperative pain hypervigilance on post-operative pain, bladder-bowel symptoms and sexual life in women undergoing vaginal surgery and to compare these parameters before and after surgery. Physical and sociodemographic, obstetric and clinical characteristics will be recorded. Pain, bladder-bowel and sexual function will be evaluated before and after surgery. The pain trigger status of the subjects will be assessed with the PVAQ, the degree to which they catastrophize pain will be assessed with the PCS and their sexual function will be assessed with the FSFI . The AOFQ will be used to assess bladder-bowel function. Postoperative pain intensity during urination and defecation will be evaluated with Visual Analog Scale.
Study Type
OBSERVATIONAL
Enrollment
77
Pain Vigilance and Awareness Questionnaire
The Turkish version of the PVAQ will be used to measure alertness to pain and pain awareness. In the 16-item Likert-type questionnaire, "never" equals 0, "rarely" equals 1, "sometimes" equals 4 and "always" equals 5 points. Items 8 and 16 of the questionnaire are reverse scored. The lowest score is 0 and the highest score is 80. A higher score indicates more pain awareness.
Time frame: Before and first day of after surgery (first postoperative day)
Pain Catastrophizing Scale
This scale was developed to measure the exaggerated negative mental reaction of individuals to existing or anticipated painful experiences and the extent to which they catastrophize pain. The validity and reliability of the Turkish version of the scale was demonstrated. It consists of 13 items, and each item is scored as never=0, slightly=1, moderately=2, greatly=3 and always=4. A high total score indicates a high degree of catastrophizing pain.
Time frame: Before and first day of after surgery (first postoperative day)
Australian Pelvic Floor Questionnaire
The Turkish version of the APFQ was shown to be valid and reliable. The scale assessing pelvic floor function has subheadings of bladder, bowel, prolapse, and sexual function. The total score ranges from 0-40. The high score indicates that severity of symptoms is high and poor sexual function.
Time frame: Before and after eight weeks of vaginal surgery
Female Sexual Function Index
FSFI was developed to assess sexual function in women. It was shown to be reliable and valid in Turkish with 19 questions. There are six sub-dimensions of sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain. Each item is scored on a 0-5 scale. An increase in the total score indicates an improvement in sexual function; an increase in the score in the pain parameter indicates a decrease in pain sensation. The scale score ranges from 2-36. The cut-off value is 26.5 to define sexual dysfunction.
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Time frame: Before and after eight weeks of vaginal surgery
Visual Analog Scale
Post-operative pain intensity during urination and defecation will be assessed with a 0-10 cm VAS before discharge. Duration of pain and factors that increased and decreased pain will recorded. The duration of first micturition, defecation, and first passing gas in the postoperative period will recorded.
Time frame: Before and first day after surgery