A recent study by Allegheny Health Network (AHN) has found that lidocaine injections can improve postoperative pain and patient satisfaction for women undergoing midurethral sling surgery to treat stress urinary incontinence (SUI), without increasing the risk of acute postoperative urinary retention (POUR).
The clinical trial, conducted by researchers at AHN Women’s Institute and published in Urogynecology, compared outcomes for patients who received retropubic lidocaine during their procedures with those who received a placebo. The results showed that those given lidocaine reported less use of pain medications, lower postoperative pain scores, and higher overall satisfaction with their surgical outcomes.
Importantly, the study determined that the use of lidocaine did not affect patients’ ability to empty their bladder after surgery. Both groups—those receiving lidocaine and those receiving placebo—had similar rates of successful bladder emptying following the procedure.
“This research represents an exciting advancement in understanding POUR among this patient population,” said Dr. Lindsay Turner, one of the lead researchers. “These findings will further guide urogynecologists providing life-changing procedures for women with urinary incontinence.”
Stress urinary incontinence is a condition caused by weakened pelvic floor muscles or urethral sphincter, often due to factors such as pregnancy, childbirth, obesity, smoking, genetics, or hormonal changes associated with menopause. SUI affects about 18 million women nationwide.
“Stress urinary incontinence impacts roughly 18 million women across the country, and unfortunately, many do not seek treatment simply because they believe in the common misconception that it’s a normal part of the aging process or a common side effect of pregnancy,” said Dr. Jessica C. Sassani. “However, there are several lifestyle modifications that can be made which can provide relief, as well as pelvic floor therapy, weight-based exercises and electrical stimulations.”
When non-surgical therapies are ineffective or when daily management includes pads or adult diapers, midurethral sling placement may be recommended. This minimally invasive procedure involves placing a sling under the urethra to support weakened muscles.
While MUS is considered a gold standard treatment for SUI, about 10-15% of patients experience temporary difficulty emptying their bladder after surgery and may require catheterization before discharge—a factor that can increase infection risk and discomfort.
Previous concerns suggested that using lidocaine injections to reduce pain might impact POUR rates; however, this study indicates otherwise.
“The lidocaine group reported less use of pain medications, lower postoperative pain scores and improved overall patient satisfaction,” said Dr. Sassani. “In addition, there was a statistically significant reduction in pain with lidocaine compared with saline at both 2 hours and 6 hours postoperatively. Therefore, we believe that this study shows that lidocaine injections should be strongly considered in all MUS procedures.”
The randomized double-blind trial included 150 participants who underwent MUS procedures between 2020 and 2024 at AHN facilities in Pittsburgh.
For more information on AHN’s Urogynecology team or to schedule an appointment visit ahn.org or call 412-DOCTORS.
