OBJECTIVE: To describe the technique and complications of vaginal repair of advanced pelvic organ prolapse using intravenous sedation, pudendal nerve block, and local anesthesia. METHODS: A retrospective review of the gynecologic surgical records of 20 patients was performed. Patient demographics, surgical procedure, surgical time, estimated blood loss, and complication rate were examined. RESULTS: All 20 patients reviewed had their operations completed without the need for general anesthesia. The surgical procedures included three anterior colporrhaphies, five anterior and posterior colporrhapies, eight vaginal enterocele repairs with anterior and/or posterior repair, and four LeFort partial colpocleises. General anesthesia was contraindicated in all patients. Patients had a mean age of 80 years (range 67-92), a mean parity of 2.7, a mean estimated blood loss of 153 mL, and a mean hospital stay of 2.1 days. One intraoperative and three postoperative complications were reported. CONCLUSION: All 20 patients had successful surgical repair under local anesthesia without the need for general induction. Surgical correction of severe pelvic organ relaxation can be performed rapidly and safely using local anesthesia, thus limiting the potential risks of general anesthesia.
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