Skip to main content
Temerty Faculty of Medicine
Search this site
Menu
Jan 12, 2026

“Most Read” Publication: Substances used in vaginal packing

Faculty, Fellows, Publication, Research, Students, Trainees

JMIG: “Vaginal Packing After Pelvic Floor Reconstructive Surgery: Does the Soaking Agent Used for Packing (Bupivacaine, Estrogen or Saline) Impact Postoperative Pain Scores?”

Doctor typing on laptop
By Matthew Tierney

Researchers from the ob-gyn department are co-authors of The Journal of Minimally Invasive Gynecology’s most-read paper in 2025, which appeared in the journal’s September 2024 issue.

The research team includes faculty members Humara Edell, Courtney Jolliffe, Louise-Helene Gagnon, Janet Bodley, Rose Kung and Patricia Lee. It also includes former U of T ob-gyn resident and fellow Tamara Abraham, former U of T resident Amanda Michael, and two former summer research students: Xinglin Li and Polina Myrox.

The prospective cohort study measured the pain levels of 210 patients who, after pelvic floor reconstructive surgery (PFRS), received vaginal packing with one of three different substances: estrogen cream, a local anesthetic called bupivacaine, or saline. The results showed no significant difference in pain scores among the three groups.

PFRS is performed to improve quality of life for people experiencing pelvic organ prolapse and urinary incontinence, conditions that can cause pain or discomfort; urinary or bowel issues; sexual dysfunction; and poor physical, emotional, and social functioning. At the completion of surgery, vaginal packing — gauze placed inside the vagina — may be used by some to prevent complications like hematoma formation. The packing is typically not placed dry but soaked with a substance. Some surgeons soak this packing in substances such as estrogen cream or local anesthetics, hoping to reduce pain and improve recovery.

Journal's instagram post announcing most-read paper of 2025 with title
JMIG’s Instagram post celebrating the #1 most-read paper of 2025.

Participants in the study received vaginal packing soaked with one of the three substances under investigation. The researchers provided a visual pain scale for patients to measure pain levels at different times after surgery: two hours, six hours and one day. They also considered secondary outcomes such as changes in blood levels, urinary retention and how long patients stayed in the hospital.

The study’s findings suggest that adding estrogen or local anesthetics to vaginal packing does not improve pain control or recovery after PFRS compared to saline-soaked packing. Saline-soaked packing appears to be just as effective, making it a simpler and more cost-effective option. They also found no significant differences in the secondary outcomes for the three groups.