Role of Hysterectomy in the Treatment of Chronic Pelvic Pain
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Hysterectomy can improve chronic pelvic pain and function in women, but 21-40% may still experience pain post-surgery, and comorbidities can affect outcomes.
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Abstract
Chronic pelvic pain affects nearly 15% of women annually in the United States. It is associated with significant comorbidity, and annual costs to the health care system are estimated at approximately 2 billion dollars per year. The multifactorial nature of chronic pelvic pain makes it difficult to evaluate and treat. Therapies vary and may include surgical interventions such as hysterectomy. Although hysterectomy is an accepted treatment for chronic pelvic pain, it has important limitations that need to be discussed with the patient before surgery. Women can expect improvement in pain levels and function from their preoperative baseline. However, studies show that in the absence of any obvious pathology, 21-40% of women having a hysterectomy for chronic pelvic pain may continue to experience pain after the surgery and 5% may have new onset of pain. Women may experience improvements in mental health, physical function, social function, and dyspareunia; however, sexual frequency is not likely to change. Comorbidities such as preoperative depression may lower the chances of pain resolution after hysterectomy. Approximately 14% of women report having results worse than expected and almost 26% may have a slower recovery than expected. To maximize the chances of pain resolution, all women with chronic pelvic pain should undergo a full evaluation of the urologic, gastroenterologic, neurologic, and musculoskeletal organ systems before surgery to exclude nonreproductive causes of pain.
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Cited by (32)
- Research Progress on Traditional Chinese Medicine in Preventing and Treating Endometriosis-Related Chronic Pelvic Pain 2026
- Use of pre-operative GnRH-analogue to predict pain outcome following hysterectomy with or without oophorectomies for chronic pelvic pain 2025
- Chronic Pelvic Pain Syndrome among women - challenge in diagnostics and management. Current literature review 2024
- Preexisting Gynecologic Conditions Associated with Chronic Pelvic Pain in Veterans Undergoing Hysterectomy for Benign Indications: Impact on Minimally Invasive Hysterectomy 2023
- ІНСТРУМЕНТИ ОЦІНКИ ХРОНІЧНОГО ТАЗОВОГО БОЛЮ У ЖІНОК 2023
- Incidence of self‐reported pelvic pain and risk factors for pain 1 year after benign hysterectomy: A register study from the Swedish National Quality Registry for Gynecological Surgery 2022
- Myofascial Pain in Hysterectomy Patients 2021
- Chronic Pelvic Pain 2021
- Evidence for Surgery for Pelvic Pain 2021
- Female Pelvic Pain 2020
- Laparoscopic uterosacral nerve block: A fertility preserving option in chronic pelvic pain 2019
- A 26-Year-Old Woman with Chronic Pelvic Pain and Negative Work-Up 2019
- Chronic pelvic pain and the role of exploratory laparoscopy as diagnostic and therapeutic tool: a retrospective observational study 2018
- Evaluation of Female Pelvic Pain 2018
- Dolor pélvico crónico en la mujer: más que una consulta ginecológica 2018
- Chronic Pelvic Pain 2018
- Hospital-associated Costs of Chronic Pelvic Pain in Canada: A Population-based Descriptive Study 2017
- Medical and surgical management of chronic pelvic pain 2017
- Histerectomía total laparoscópica en pacientes con endometriosis profunda 2016
- Comparative Analyses of Pain, Depressed Mood and Sleep Disturbance Symptoms in Women before and after Hysterectomy 2015
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- Indications and Alternatives to Hysterectomy 2014
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- Total Laparoscopic Hysterectomy: Overtreatment for Misdiagnosed Organic cause or Undertreatment for Idiopathic Chronic Pelvic Pain? 2014
- Surgical Evaluation and Treatment of the Patient with Chronic Pelvic Pain 2014
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- Pelvic Inflammatory Disease and Chronic Pelvic Pain 2012
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