Biopsychosocial correlates of persistent postsurgical pain in women with endometriosis

OBJECTIVE: To examine pain and biopsychosocial correlates over time for women with persistent postsurgical pain after surgery for endometriosis. METHODS: Cross-sectional study of women who underwent any endometriosis surgery between 2003 and 2006. Following surgery, patients completed validated questionnaires (Short-Form McGill Pain Questionnaire, 12-item Short-Form Health Survey, Beck Depression Inventory, Coping Strategies Questionnaire catastrophizing subscale). The primary outcome was pelvic pain intensity, measured by the McGill total pain score. Bivariate comparisons between each potential predictor and pain intensity were performed using the χ(2) and t tests, 1-way analysis of variance, and simple linear regression. RESULTS: In total, 79 completed the questionnaires and were included in the present analysis. The McGill affective pain score was negatively correlated with age (β-coefficient -0.12, P=0.002) and positively correlated with catastrophization (β-coefficient 0.66, P=0.01). Women with a history of dyspareunia scored significantly higher on the McGill total pain score (P<0.001); there was no association between pain intensity and endometriosis severity. CONCLUSION: Younger age and catastrophization are correlated with persistent pain following surgery for endometriosis. The severity of endometriosis does not predict persistent pain. Further evaluation of psychosocial factors may identify patients who are least likely to benefit from surgeries for endometriosis-associated pelvic pain.