Patient Satisfaction and Pain Control Following Reconstructive Vaginal Surgery

The investigators hypothesize that patient controlled analgesia (PCA) provides superior pain
relief and patient satisfaction when compared to scheduled intravenous analgesia following
vaginal reconstructive surgery.

In order to determine if there is a significant correlation, secondary outcomes will include
the daily and total narcotic volume used, common side effects from the opioid including
nausea, vomiting, or pruritis, length of hospital stay, timing of flatus and first bowel
movement, all complications, and procedure performed.

Inclusion Criteria:

- The patients will be limited to those from the Division of Urogynecology to ensure
similar surgical techniques. They will be between the ages of 18 and 70 and undergoing
major vaginal reconstruction.

- All patients must undergo vaginal reconstructive surgery including: anterior repair,
posterior repair, and intraperitoneal vaginal vault suspension. The addition of
vaginal hysterectomy, enterocele repair, or suburethral sling is not cause for
exclusion.

Exclusion Criteria:

- Any patient who has an allergy to hydromorphone/Dilaudid.

- Any patient already taking chronic opioids, defined as daily use.

- All patients with renal insufficiency or failure.

- All patients with liver failure.

- Any patient who is not having general anesthesia.

- Any patient undergoing abdominal or laparoscopic procedures: sacral colpopexy,
laparoscopic hysterectomy or oophorectomy, Burch procedure, or any procedure that
enters the abdominal fascia.