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Low back pain does not improve with surgical treatment of pelvic organ prolapse

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Abstract

Introduction and hypothesis

Our goal was to determine if there is a correlation between low back pain (LBP) and pelvic organ prolapse (POP) by assessing for change in LBP after surgical correction of prolapse.

Methods

Patients undergoing POP surgery were recruited to participate. They completed the Oswestry Disability Index (ODI), a validated back pain questionnaire, at their preoperative and postoperative visits at 1, 3, and 6 months. A higher ODI score (0–100) represents more severe disability. A 9-point change represents a minimal clinically important difference (MCID). The primary outcome was the change in ODI scores from preoperative to 3 months postoperative. We analyzed ODI scores with repeated measures analysis of variance (ANOVA). Power analysis showed that a sample size of 50 was needed for 88 % power to resolve a MCID on ODI.

Results

A total of 51 patients were recruited and 43 (84 %), 34 (67 %), and 36 (71 %) completed the 1-, 3-, and 6-month follow-up, respectively. The mean ODI scores at the preoperative and the 1-, 3-, and 6-month postoperative visits were 15, 19, 9, and 9. The mean ODI score from preoperative to 3 months postoperative improved by 5 points [confidence interval (CI) −9.2 to −0.5, p = 0.03]. Of the participants 7 (20.6 %, CI 11–35 %) experienced a MCID improvement, 24 (70.6 %, CI 56–83 %) reported no substantial change, and 3 (8.8 %, CI 3–20 %) experienced a MCID worsening.

Conclusions

Our study found a statistically significant but not clinically significant improvement of LBP after surgical repair of prolapse.

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Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Massachusetts General Hospital, 55 Fruit St. Founders 444, Boston, MA, 02114, USA

    Trevin Lau

  2. Urogynecology and Pelvic Reconstructive Surgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA

    Milena Weinstein, May Wakamatsu & Samantha Pulliam

  3. Massachusetts General Hospital, Biostatistics Center, 50 Staniford St., Suite 560, Boston, MA, 02114, USA

    Eric A. Macklin

Authors
  1. Trevin Lau
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  2. Milena Weinstein
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  3. May Wakamatsu
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  4. Eric A. Macklin
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  5. Samantha Pulliam
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Corresponding author

Correspondence to Trevin Lau.

Appendices

Scaling and scoring of the Oswestry Disability Index (ODI)

figure afigure a

ODI version 2.1a

figure b

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Lau, T., Weinstein, M., Wakamatsu, M. et al. Low back pain does not improve with surgical treatment of pelvic organ prolapse. Int Urogynecol J 24, 147–153 (2013). https://doi.org/10.1007/s00192-012-1797-9

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  • DOI: https://doi.org/10.1007/s00192-012-1797-9

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