Effect of Pain Vigilance on Pain Catastrophizing, Bladder-Bowel Function and Sexual Life: A Comparative Study of Before-After Vaginal Surgery

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.