Perioperative Pain Management in Urogynecology: A Review

Postoperative pain after pelvic reconstructive surgery is inseparably tied to care quality, patient experience, and demands on the health care system. Pelvic reconstructive surgeons have considerably advanced our knowledge of postoperative pain after procedures and of perioperative interventions to address postoperative pain. This narrative aims to provide helpful information to surgeons as we continue to prioritize patient-centric outcomes, lower costs, and the risks of long-term opioid use. In this review, we present an overview of pain processing pathways. Then we discuss the natural history of pain after urogynecologic surgical procedures, followed by a review of the existing literature on interventions and systems to reduce postoperative pain. We also highlight considerations for future research. While public health and epidemiologic considerations are critical in the context of opioid burden, these are beyond the scope of this review.