Manjula Annappa
Manjula AnnappaConsultant Obstetrician & Gynaecologist, Clinical Lead, Diana, Princess of Wales Hospital, United Kingdom

Question: I work with women who have undergone sacrospinous fixation surgery. In the past, some patients have found it more comfortable to sit with the use of a foam cushion post-operatively. There has been some recent discussion that patients should not sit on a cushion (with perineal cut out) after having this procedure. Can you provide any evidence or point to any literature to explain why a flat foam cushion can or cannot be used?

Answer: There is no literature that addresses sitting upright and/or the use of cushions for sitting following a sacrospinous fixation procedure.

One in ten women have buttock pain following this procedure due to bruising of the S3 and S4 nerve roots. However, simple NSAIDs/analgesics typically resolve this pain within a few weeks. It is very rare to see patients with severe and long-lasting pain. If this is the case, the stitches should be removed rather than leaving it for too long.

Patients can sit upright following this procedure. There is no contraindication for using a cushion if the patient finds that more comfortable.

Dr. Lynsey Hayward (New Zealand) presented a small study on sacrospinous ligament fixation and post-operative pain at the 2018 IUGA Annual Meeting. Her presentation is available in the IUGA Academy.*

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