Prediction of chronic pelvic pain after adenomyosis surgery: an observational comparative study

Jingjing Zhang, Juan Sun, Xiaohang Ye, Xiaolei Yang, Wei Jin, Le Bu
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2026 · vol. 46(1) , pp. 2739152 · doi:10.1080/01443615.2026.2739152 · PMID:42832698 · W7220412977
Observational OA: gold public-domain-us
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This study developed a predictive model for chronic pelvic pain after adenomyosis surgery, identifying high preoperative CMSS scores, CA125 levels, and diffuse-type adenomyosis as independent risk factors.

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Abstract

BACKGROUND: Chronic pelvic pain (CPP) remains a common and clinically challenging outcome after uterus-preserving surgery for adenomyosis. Identifying patients at higher risk of postoperative CPP may facilitate individualised postoperative management. METHODS: The clinical data of 150 patients with adenomyosis admitted to our hospital from January 2022 to January 2025 were prospectively collected for observation. Uterine volume, Pictorial Blood Loss Assessment Chart (PBAC) score, Cox Menstrual Symptom Scale (CMSS) score, cancer antigen 125 (CA125) level, haemoglobin (Hb) level, and three-level version of the EuroQol five-dimensional questionnaire (EQ-5D-3L) score were recorded preoperatively and at 3 and 6 months postoperatively. Patients were divided into CPP (n = 38) and non-CPP (n = 112) groups based on 6‑month CPP status. Independent risk factors were identified using logistic regression, and a predictive model was developed and validated. RESULTS: Significant improvements were observed in uterine volume, PBAC score, CMSS score, CA125 level, and Hb level postoperatively (P < 0.05). EQ-5D-3L scores improved in usual activities, pain/discomfort, and anxiety/depression (P < 0.05). Preoperative CMSS score, CA125 level, and diffuse-type adenomyosis were identified as independent factors associated with CPP, while preoperative hormonal pre-treatment and postoperative regular hormonal therapy showed significant associations in univariate analysis. The predictive model incorporating these variables showed good calibration (Hosmer-Lemeshow χ2 = 15.477, P = 0.051) and strong discrimination (AUC = 0.820, 95% CI: 0.743-0.897). At the maximum Youden's index (0.567), sensitivity was 76.30% and specificity was 80.40% (P < 0.001). CONCLUSION: High preoperative CMSS score, high CA125 level, and diffuse-type adenomyosis are independent risk factors for postoperative CPP, while preoperative hormonal pre-treatment and postoperative regular hormonal therapy may be associated with a lower risk of CPP. The predictive model effectively identifies high-risk patients, supporting targeted nursing interventions.

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MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Pelvic Pain Pelvic Pain Pelvic Pain

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (26)

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