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The aim of this study was to establish if digitally guided pre-emptive pudendal block (PD reduces postoperative pain and facilitates recovery after posterior vaginal repair under local anesthesia and sedation. We carried out a prospective, randomized, double-blind trial in an outpatient surgery facility. Forty-one women between 18 and 70years of age, scheduled for primary posterior vaginal reconstructive outpatient surgery, completed the study. The surgery was performed using sedation and local anesthesia with bupivacaine/adrenaline. At the end of surgery