AHN Study: Injected Lidocaine Improves Post-Sling Pain and Patient Satisfaction Without Increasing Urinary Retention Rates Among Surgical Population

PITTSBURGH, Feb. 13, 2026 /PRNewswire/ -- For women who undergo a surgical procedure to improve urinary incontinence symptoms, lidocaine injections improve postoperative pain, and do not impact the patient's ability to empty their bladder in the days following surgery, according to a new AHN study.

The findings have the potential to change the postoperative recovery plan and improve outcomes for women who need the midurethral sling surgery. 

The clinical trial results, published in Urogynecology by researchers at Allegheny Health Network's Women's Institute, showed that patients who receive retropubic lidocaine — a widely used local anesthetic — during midurethral sling placement report lower postoperative painkiller use, improved postoperative pain, and better overall satisfaction with surgical outcomes compared to their placebo counterparts.

Most notably, the use of lidocaine did not increase acute postoperative urinary retention (POUR) following the procedure to treat stress urinary incontinence (SUI), with the same number of patients being able to empty their bladder successfully in both the lidocaine and placebo groups.

Jessica C. Sassani, MD, Charlie Miller, MD, and Lindsay Turner, MD of AHN Women's Institute were lead researchers of the trial.

"This research represents an exciting advancement in understanding POUR among this patient population," said Dr. Turner. "These findings will further guide urogynecologists providing life-changing procedures for women with urinary incontinence."

The female bladder is located behind the pubic bone and is emptied through a tube called the urethra. In patients experiencing SUI, the muscle responsible for opening and closing the bladder — called the urethral sphincter — as well as pelvic floor muscles have typically been weakened due to causes like pregnancy and childbirth, obesity, smoking, genetics, and hormonal changes like the menopause transition.

The weakened muscles can result in the involuntary leakage of urine; SUI leakage is caused by sneezing, coughing, laughing or exercise, and the overall lack of control on the bladder can lead to stress, anxiety and a lower quality of life for many women.

"Stress urinary incontinence impacts roughly 18 million women across the country, and unfortunately, many do not seek treatment simply because they believe in the common misconception that it's a normal part of the aging process or a common side effect of pregnancy," said Dr. Sassani. "However, there are several lifestyle modifications that can be made which can provide relief, as well as pelvic floor therapy, weight-based exercises and electrical stimulations."

But, when these therapies prove ineffective, or if pads or adult diapers have become a part of a woman's care plan, a midurethral sling (MUS) placement may be prescribed. A minimally invasive procedure, the sling is placed under the urethra to offer increased support to the muscle.

SUI is a specific type of urinary incontinence caused by muscle weakness; incontinence caused by neurological damage or overactive bladder muscles is generally classified as "urge incontinence" and is not remedied by the midurethral sling procedure.

Although considered the gold standard of permanent SUI treatment, roughly 10-15% of all women have trouble emptying their bladder for a few days postoperatively and will be discharged with a catheter, which can increase their risk of urinary tract infections and subsequent pain.

Previously, the assumption was that lidocaine injections to minimize pain may impact POUR rates; however, this study shows that lidocaine does not increase or decrease the incidence of POUR.

The study was a randomized, double-blind and placebo-controlled trial of 150 participants undergoing MUS procedures between 2020 – 2024 at AHN facilities in the Pittsburgh region. In the medication group, retropubic lidocaine was injected and all participants were asked to void their bladder approximately two hours after surgery and record their pain following hospitalization.

"The lidocaine group reported less use of pain medications, lower postoperative pain scores and improved overall patient satisfaction," said Dr. Sassani. "In addition, there was a statistically significant reduction in pain with lidocaine compared with saline at both 2 hours and 6 hours postoperatively. Therefore, we believe that this study shows that lidocaine injections should be strongly considered in all MUS procedures."

For more information on the AHN Urogynecology team or to make an appointment, visit ahn.org or call 412-DOCTORS.

About Allegheny Health Network: 
Allegheny Health Network (AHN.org), is an integrated healthcare delivery system serving the greater Western Pennsylvania region. The Network is composed of 14 hospitals, ambulatory surgery centers, Health + Wellness Pavilions, multiple employed physician organizations, home and community-based health services, a research institute, and a group purchasing organization. The Network provides patients with access to a complete spectrum of advanced medical services, including nationally recognized programs for primary and emergency care, trauma care, cardiovascular disease, organ transplantation, cancer care, orthopedic surgery, neurology and neurosurgery, women's health, diabetes, autoimmune disease and more. AHN employs approximately 23,000 people, has more than 2,500 physicians on its medical staff and serves as a clinical campus for Drexel University College of Medicine and the Lake Erie College of Osteopathic Medicine.  

SOURCE Allegheny Health Network