Survey of use of local infiltration and vasoconstrictors in vaginal surgery

To survey the practice and reasons of use of local infiltration in prolapse and continence surgery in UK, an electronic survey of gynaecologists with special interest in urogynaecology, urogynaecologists, urologists and allied professionals who were on the email list of the International Continence Society (ICS), UK was carried out in April-July 2006. Out of the 238 questionnaires that were sent, 112 failed mail delivery and 57 questionnaires were returned, giving a response rate of 50.1%. Of the respondents, 40/46 (86.9%) used local infiltration for vaginal hysterectomy and vaginal repairs, whilst 43/46 (93.4%) used it for TVT. Of the respondents, all of 18 who performed vaginal mesh procedures used local infiltration. While 90% of respondents felt it helped reduce blood loss, only 46% were convinced that it helped reduce visceral injury. The survey reflects that the majority use local infiltration for gynaecological surgery: however, there is wide variation in the type and strengths of agents used.