Incidence and association factors for the development of chronic post-hysterectomy pain at 4- and 6-month follow-up: a prospective cohort study

Ban Leong Sng, Yin Ying Ching, Nian-Lin Reena Han, Farida Ithnin, Rehena Sultana, Pryseley Nkouibert Assam, Alex Tiong Heng Sia
In: Journal of Pain Research · 2018 · vol. Volume 11 , pp. 629–636 · doi:10.2147/jpr.s149102 · PMID:29628772 · PMC5877488 · W2794733436
article OA: gold CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This prospective study of 216 women found 32% developed chronic post-hysterectomy pain at 4 months, decreasing to 15.7% at 6 months, with several preoperative and perioperative factors associated with its development.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This prospective cohort study enrolled 216 Asian women undergoing elective abdominal or laparoscopic hysterectomy for benign indications and used preoperative measures (anxiety, pain catastrophizing, and mechanical temporal summation testing) plus perioperative data, followed by phone surveys at 4 and 6 months to identify chronic post-hysterectomy pain (CPHP) and functional impairment. CPHP incidence was 32% at 4 months and 15.7% at 6 months; women with CPHP reported pain interfering with activities of daily living, and the authors note that central sensitization-related mechanisms were implicated. Independent association factors for CPHP at 4 months included higher mechanical temporal summation, higher intraoperative morphine consumption, higher recovery-room pain, higher pain during coughing and itching at 24 hours, and preoperative lower abdominal pain, while at 6 months the independent factors included preoperative pain during sexual intercourse, higher mechanical temporal summation, and higher morphine consumption at 24–48 hours. This paper excludes participants with endometriosis (and mainly focuses on benign indications including fibroids and adenomyosis), so its relationship to endometriosis is limited to explicit exclusion of endometriosis.

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Abstract

Chronic pain has major adverse effects on health-related quality of life and contributes to significant socioeconomic burden. Hysterectomy is a very common gynecological surgery, resulting in chronic post-hysterectomy pain (CPHP), an important pain syndrome. We conducted a prospective cohort study in 216 Asian women who underwent abdominal or laparoscopic hysterectomy for benign conditions. Demographic, psychological, and perioperative data were recorded. Postoperative 4- and 6-month phone surveys were conducted to assess the presence of CPHP and functional impairment. The incidence rates of CPHP at 4 and 6 months were 32% (56/175) and 15.7% (25/159), respectively. Women with CPHP at 4 and 6 months had pain that interfered with their activities of daily living. Independent association factors for CPHP at 4 months were higher mechanical temporal summation score, higher intraoperative morphine consumption, higher pain score in the recovery room, higher pain score during coughing and itching at 24 hours postoperatively, and preoperative pain in the lower abdominal region. Independent association factors for CPHP at 6 months were preoperative pain during sexual intercourse, higher mechanical temporal summation score, and higher morphine consumption during postoperative 24 and 48 hours. In a majority of cases, CPHP resolved with time, but may have significant impact on activities of daily living.

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