Outcome of hysterectomy for pelvic pain in premenopausal women

S K Tay, Sun‐Kuie Tay, Tay SK, Bromwich N, N Bromwich, Nicki Bromwich
The Australian & New Zealand journal of obstetrics & gynaecology · 1998 · vol. 38(1) , pp. 72–76 · doi:10.1111/j.1479-828x.1998.tb02963.x · PMID:9521396 · W1970141640
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Abdominal hysterectomy for premenopausal women with pelvic pain resulted in symptom relief for 95.8% of respondents and satisfaction for 87%, irrespective of identifiable pathology.

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Abstract

The outcome of abdominal hysterectomy for pelvic pain in premenopausal women was studied retrospectively in 228 women. In 17 women, pelvic pain was the sole indication while in the others, pelvic pain was one of the contributory indications for hysterectomy. The most common surgical histopathological diagnoses were uterine leiomyoma (73.9%), uterine adenomyosis (40.4%), benign ovarian cyst (19.3%) and endometriosis (7.9%); 118 (51.8%) patients had single pathology and 48.2% had multiple pathologies. The agreement between operative clinical diagnosis and histopathological diagnosis was 66.1% for leiomyoma, 57.1% for uterine adenomyosis and 30% for endometriosis. The incidence of early postoperative complication was 20.6%, mainly minor morbidities including urinary tract infection (3.9%), wound infection (3.1%) and unexplained fever (6.0%). These complications significantly prolonged the duration of hospital stay from an average of 7 days to 9-17 days. Of 98 patients with pain as the sole or the most predominant indication for hysterectomy, 72% responded to an outcome survey 12 or more months after hysterectomy. Of these, 62 (87%) were satisfied with the operation, 8 were unsure and 1 was dissatisfied; 68 (95.8%) patients reported relief of their symptoms. Relief of symptoms did not correlate with the patient's report of her satisfaction with hysterectomy. Pain in the abdominal wound a year or more after surgery was one of the commonest reasons cited for dissatisfaction with hysterectomy. We conclude that in well-selected cases, hysterectomy is an appropriate and satisfactory treatment for premenopausal women with pelvic pain irrespective of clinical evidence of associated pathology. Effective measures to reduce postoperative complications and wound pain are needed to further improve the outcome of abdominal hysterectomy.

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Condition tags

endometriosischronic_pelvic_painadenomyosis

MeSH descriptors

Hysterectomy Hysterectomy Pelvic Pain Premenopause Premenopause Adult Adult Chronic Disease Chronic Disease Endometriosis Endometriosis Endometriosis Female Female Humans Humans Leiomyoma Leiomyoma Leiomyoma Middle Aged

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References (18)

Cited by (16)

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