Symptom resolution after hysterectomy and alternative treatments for chronic pelvic pain: does depression make a difference?

Lee A. Learman, Steven E. Gregorich, Michael Schembri, Alison Jacoby, Rebecca A Jackson, Rebecca Jackson, Miriam Kuppermann
American journal of obstetrics and gynecology · 2011 · vol. 204(3) , pp. 269.e1–269.e9 · doi:10.1016/j.ajog.2010.12.051 · PMID:21376168 · W2036507395
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This study investigated whether depression influences symptom resolution following hysterectomy and alternative treatments for chronic pelvic pain.

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Abstract

OBJECTIVE: The purpose of this study was to determine whether depression influences treatment outcomes and to identify predictors of symptom resolution among women with chronic pelvic pain (CPP). STUDY DESIGN: Analysis of 701 women with CPP in the Study of Pelvic Problems, Hysterectomy and Intervention Alternatives prospective cohort study, which included 153 women (22%) with depression. We conducted multivariable analyses to evaluate the influence of depression on pre-/posttreatment differences in symptoms and health-related quality of life and to identify other predictors of symptom improvement. RESULTS: CPP treatments included hysterectomy (9%), other surgical treatments (9%), hormonal medications (50%), narcotic analgesics (47%), physical therapy (12%), and nonprescription medications (93%). Depression predicted lower gains in health perception (P < .05) but not in symptom resolution, sexual functioning, or other aspects of health-related quality of life. Symptom resolution was predicted by hysterectomy (P < .001), entering menopause (P < .001), and pretreatment satisfaction with sex (P = .039). CONCLUSION: Depression does not influence substantially treatment-related gains in CPP symptom resolution and health-related quality of life. Coexisting depression should not delay treatment for CPP.

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Condition tags

chronic_pelvic_pain

MeSH descriptors

Depressive Disorder Hysterectomy Pelvic Pain Adult Chronic Disease Depressive Disorder Female Humans Middle Aged Pelvic Pain Pelvic Pain Pelvic Pain Pelvic Pain Physical Therapy Modalities Treatment Outcome

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