Hysterectomy for chronic pelvic pain of presumed uterine etiology
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This study found that hysterectomy for chronic pelvic pain of presumed uterine origin resulted in significant improvement for 77.8% of women, while 22.2% experienced persistent pain.
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Abstract
This study evaluates the long-term outcome of 99 women who underwent hysterectomy for pelvic pain of at least 6 months' duration. All had symptoms and physical examination findings suggestive of disease confined to the uterus. Patients were excluded if there was previously documented extrauterine pelvic disease, extrauterine pelvic disease at the time of surgery, or uterine weight exceeding 200 g. Histopathologic analysis revealed leiomyomata in 12 (12.1%), adenomyosis in 20 (20.2%), and both leiomyomata and adenomyosis in two (2.02%). The average uterine weight was 91.1 g (range 24-198). Patients were followed after hysterectomy for an average of 21.6 months (range 15-64), with 77 of 99 (77.8%) showing significant improvement and 22 (22.2%) having persistent pelvic pain. Despite preoperative history and physical findings suggesting and histologic findings confirming uterine disease, nearly a quarter of the patients had persistent pelvic pain after hysterectomy for chronic pelvic pain. These findings should have a significant impact on the therapeutic choices recommended by gynecologists and may alter the informed consent that patients give in such cases.
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Cited by (50)
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- 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
- If Everything Else Fails 2021
- “A Clinical Study on Chronic Pelvic Pain in Gynecology” 2021
- Incidence and predictors of persistent pelvic pain following hysterectomy in women with chronic pelvic pain 2021
- Chronic Pelvic Pain 2021
- Impact of hysterectomy on analgesic, psychoactive and neuroactive drug use in women with endometriosis: nationwide cohort study 2020
- Pelvic Pain: Clinical Features 2019
- The Investigation and Management of Adenomyosis in Women Who Wish to Improve or Preserve Fertility 2018
- No. 164-Consensus Guidelines for the Management of Chronic Pelvic Pain 2018
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- Hospital-associated Costs of Chronic Pelvic Pain in Canada: A Population-based Descriptive Study 2017
- Hysterectomy in the Surgical Management of Endometriosis 2017
- Surgical interventions for chronic pelvic pain 2016
- Salpingo-oophorectomy at the Time of Benign Hysterectomy: A Systematic Review 2016
- Comparative Analyses of Pain, Depressed Mood and Sleep Disturbance Symptoms in Women before and after Hysterectomy 2015
- Adenomyosis: A Clinical Review of a Challenging Gynecologic Condition 2015
- Approaches to Hysterectomy 2015
- [Indications and methods of hysterectomy] 2014
- Does the uterine cervix become abnormally reinnervated after subtotal hysterectomy and what is the association with future trachelectomy? 2014
- Surgical evaluation and treatment of the patient with chronic pelvic pain 2014
- Psychological Aspects of Hysterectomy & Postoperative Care 2012
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- Gynecologic Etiologies of Chronic Pelvic Pain 2012
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- The Role of Definitive Surgery in the Management of Chronic Pelvic Pain and Posthysterectomy Pain 2011
- Adenomiose em pacientes com endometriose profunda: aspectos clínicos, histológicos e radiológicos 2010
- Medical, surgical and alternative treatments for chronic pelvic pain in women: a descriptive review 2009
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- Chronic pain after hysterectomy 2008
- Dilemmas in diagnosing pelvic pain: multiple pelvic surgeries common in women with interstitial cystitis 2007
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- Chronic pelvic pain: Aetiology and therapy 2006
- Adenomyosis: not such an elusive diagnosis any longer 2006
- Laparoscopic findings, histopathologic evaluation, and clinical outcomes in women with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy 2006
- Chronic pelvic pain: the occurrence of interstitial cystitis in a gynecological population 2006
- Interstitial cystitis in persistent posthysterectomy chronic pelvic pain 2005
- Chronic pelvic pain in women: evaluation and management in primary care 2005
- Consensus guidelines for the management of chronic pelvic pain 2005
- Hysterectomy: effects on quality of life and psychological aspects 2005
- Chronic Pelvic Pain in Men and Women: Pathogenesis, Diagnosis, and Treatment 2004
- Surgical management of endometriosis 2004
- The role of laparoscopy in the diagnosis and treatment of conditions associated with chronic pelvic pain 2004
- The role of laparoscopy in the chronic pelvic pain patient 2003
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